Does this sound familiar: you’re running multiple point-of-care systems, each with redundant data points collected. But what happens when there are small variations in how data is captured and processed across these systems? As a healthcare provider client of ours discovered, inconsistent data can reduce revenue realization. It caused claims to be improperly matched and […]
Posts Tagged ‘claims processing’
5 Tips for Transparency in Claims Processing Using Data Governance
What are the business rules that companies are using for claims processing? This is a common question when it comes to performing analysis on claims data and is becoming increasingly important with regulations on billing transparency on the way. The logic used for claims processing is typically embedded in code and is not transparent to […]
How Watson and BPM Are Disrupting Insurance
If there’s one area that can spell the success or failure of an insurance carrier, it’s claims. Claims consume nearly 80% of insurance premiums in the form of payments or processing costs. Consequently, claims managers are challenged to reduce these costs, improve service levels, and gain greater control over the processing environment. As regulatory oversight […]