Microdea’s Synergize for Claims Processing enables insurance organizations to retrieve, automatically route, and manage claims related information from a single and secure location. Synergize streamlines claims processing, eliminates inconsistencies, monitors service level agreements concerning the adjudication of claims, and reduces costs by providing efficient access to claims documents and automating time-consuming, labour intensive tasks through electronic workflow.
Claims processing is one of the most critical activities to maintaining positive customer relationships and overall brand strength. However, it is also a very complex and difficult process to manage due to highly inefficient and costly paper-driven processes. The result can be inaccurate data, poor productivity, lack of responsiveness to customers, and mishandled claims.
Insurance organizations face mounting pressures to cut operational costs, expedite claims processing times, validate claims amounts, improve customer service and stay competitive. To optimize their business processes, access to secure electronic documents is vital.
Synergize for Claims Processing utilizes document scanning and imaging to improve document management and workflow capabilities. Claims documents are easily retrievable from a web-based central repository to speed processing, and electronic workflow automates the validation of data, activation of exception alerts, and forwarding of documents to the appropriate personnel. This ensures that labour-intensive tasks such as manually storing, locating, printing, and mailing documents are avoided, and claims are processed in a timely manner consistent with corporate best practices.
The image below illustrates a simple claims workflow. The Synergize Workflow Designer is capable of building complex workflows to accommodate more elaborate processes.
Workflow monitors the process to verify that each person handling the claim executes the appropriate steps and fulfills their designated responsibilities. Each step of the process is confirmed to be complete before proceeding. For example, service level agreements can be set and monitored to ensure that if the adjudication of a claim is not completed within 24 hours then management is automatically sent an email notification. Insurance organizations are thereby able to consistently deliver superior service and maintain a reputable brand in the market.
Synergize for Claims Processing provides:
- Fast, accurate scanning and capture of paper, email, fax or EDI
- Standardized claims processing with predictable and reliable business outcomes
- Quicker turnaround and more accuracy
- Greater responsiveness, improved service levels and increased customer retention
- Efficient and effective integration of systems, employees and third-party claims processing participants
- Lower administrative costs as more claims are processed in less time without requiring additional staff
- Reduced costs associated with processing, storing, printing, mailing, and losing or misplacing documents
For more information on how Microdea can help your insurance organization automate claims processing and increase profits, contact us at 905.881.6071 ext 244 or marketing@microdea.com