Insurance claims management software is required for smooth claim processing, which is a mission-critical part of any insurance handling routine, and health policies are no exception. Health insurance claims management solutions are highly instrumental at all stages of this procedure—from submitting a claim through its processing to a compensation payment.
Benefits of custom health insurance claims management software
Leveraging a first-rate claims management product ushers in some weighty boons for insurance organizations and their customers.
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Contact usFeatures of custom health claims management software development
The best-in-class custom solution should perform all claims management functions in health insurance. We distinguish customer-facing features from those used by insurance company employees. So, here is a breakdown of useful functionalities.
Customer-facing functionalities
Online claim filing
In a modern world, it is critical to have the possibility to submit an insurance claim whenever and wherever you are. So, we offer web and mobile solutions for health claim submissions.
Making appointments with doctors
Our solutions will allow your customers to schedule appointments with doctors on their own. It helps insurers decrease workload on call centers and reduce operational costs.
Claim status monitoring
As soon as a claim is accepted, adjudicated, validated, satisfied, or disbursed, the claimant obtains a notification about the change in claim status.
Auto-filling of customer data
To save a claimant’s time and effort, software should automatically insert previously entered or saved information about the customer (such as their name, birth date, policy number, etc.) when they start to type it on the keyboard.
Online payments
If the insured event has been validated, customers should obtain disbursement via a secure payment capability.
Online access to the FAQ
By visiting this section, customers can get answers to standard questions regarding the claims processing routine and solve a fair share of issues they may face while filing a claim.
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Insurer-facing functionalities
Claim intake
Insurers automatically receive claims and are assigned specific tasks according to the pre-defined rules and workflows.
Document management
Insurers should have 24/7 access to all claim-related documents (claim application, policy, medical evidence, bank account number, etc.) to make data-driven decisions and accelerate claim processing workflows.
Data analytics
Our solutions provide solid analytics and BI capabilities to analyze claim data and generate respective reports according to your needs and strategies.
Bulk processing
We also develop health insurance management platforms for group insurance purposes, where bulk processing is of vital importance. Moreover, our ready-made software product for corporate insurance can be easily implemented if you have such needs.
Integrations with other solutions
Modern insurance companies rely on a ramified digital environment to provide their services. Health insurance claims management software should dovetail into this multifunctional system and allow its users to move around it smoothly.
Integration possibilities
Obviously, a health claim management software doesn’t work on its own. It can’t work separately from other systems that usually provide data and support important processes like invoicing, billing, payments, etc. So, it is critical to integrate health claim processing with other systems like Electronic Health/Medical Records, billing systems, payment gateways, and CRM systems. Our team is experienced in system integration, considering best practices and insurance company needs. Below is a list of systems we can ensure effective integration with:
- Core insurance
- Data warehouse
- EMRs/EHRs
- Billing systems
- CRM tools
- Payment gateways
Why choose DICEUS for health insurance claims management software development?
About DICEUS
Our achievements
Our services
The vetted experts of DICEUS provide the entire range of custom health insurance claims management software development services that cover all IT needs of an insurance company in this domain.
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Client reviews
Elena Markova
Board Member, UNIQA Ukraine
We were impressed by the depth of the UX analysis they did in terms of our customer’s research, buyer persona creation, user journey mapping, etc. All the information like research findings, for instance, was presented in a clear form (presentations, Miro boards, clear infographics) so it was quite easy to understand what we need to build and why.
Antoaneta Karagyozova
CPSO, Fadata
We are happy with DICEUS’ software implementation services. The team’s workflow is highly effective and professional in all aspects of the engagement. All clearly understand what goals we’d like to reach and do their best to do that as efficiently as possible. Overall, the partnership has been successful.
Phil Reynolds
CEO, BriteCore
The DICEUS team has consistently supported the BriteCore team for many years. Their engineers are well-educated and highly invested in the ongoing quality of the BriteCore platform with sustained relationships that extend over four years. We appreciate everything the DICEUS team brings to the table as a development partner.
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FAQ
What is health insurance claims management software?
It is a complex of IT products that insurance companies leverage to streamline and facilitate the health claim management pipeline. The ecosystem covers all aspects of claim handling, including claim filing, claim progress tracking, document management, online payments, and more.
How does claims adjudication software contribute to health insurance processes?
Solutions of this kind automate the lion’s share of related workflows, such as claims adjudication and auto-adjudication, benefit administration, enrollments, and billing. Thanks to them, insurance organizations can quickly and efficiently assess claims for coverage, medical necessity, and contract agreements.
How can patient billing and claims software improve financial workflows?
By integrating this module into their professional IT environment, insurance companies boost their financial workflows due to enhanced accuracy, error minimization, facilitated cash flow, perpetual regulatory compliance, and improved financial reporting capabilities.
What technologies and trends drive digital claims processing in health insurance?
Artificial Intelligence is the principal technology that will shape the contours of claim processing in health insurance in the foreseeable future. Its chief use case in the niche is fraud detection and prevention through firm billing control. Besides, AI will surely become an intelligent instrument for checking claims against prewired codes, policies, or providers and powering chatbots that will radically boost customer service.
What benefits does claims workflow automation technology bring to healthcare providers?
Companies that introduce a high degree of automation into their claims handling pipeline minimize the negative effect of human factors (errors, oversights, and negligence), improve the organization’s efficiency and productivity, step up risk management, provide non-stop regulatory and SLA compliance, and augment the overall level of services they offer.
