Health Insurance Claims Management

Medical claims processing systems software

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Health insurers are challenged with high standards for customer service delivery and rigid compliance to government regulations. This makes the efficiency of time, data and business process management essential to success.

The following processes need to be supported by Health Insurance Claims Management Software:

CMW Health Insurance Claims Management software provides for effective claims processing and enables elimination of inconvenient and error-prone paper and email-based operations taking all communications, data and processes into a unified working environment.

It ensures 100% compliance with regulations as well as increases the overall team performance and resource utilization. With CMW Health Insurance Claims Management software you will be able to increase the amount of claims processed, strictly adhere to the SLA’s and increase your customer satisfaction.

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Health Insurance Claim Processing

Empower your health insurance claims processing workflow with advanced data capture and routing technology within days, not months, and get an immediate positive impact on your business.

  • Full automation and elimination of operational inefficacies and legacy issues
  • Visual workflow editor for easy health insurance claim process design and Business Rules setup
  • Timely and accurate health insurance claim routing and notifications
  • Sequential or parallel workflows to specify whether documents are reviewed and approved in a specific order or by multiple reviewers at the same time.
Health Insurance Claim Processing  Health Insurance Claim Processing

Agile Health Insurance Claim Process

Scale on the fly, tailor to your specific business needs and requirements - your health insurance claims management solution ensures delivery of the highest possible ROI.

  • Automatic claim route by product, amount, department or any field data
  • Both manual and automatic claims routing and processing based on configurable business rules
  • On-the-fly changes to web-forms and processes
  • Enhanced operational efficiency
Agile Health Insurance Claim Process  Agile Health Insurance Claim Process

Health Insurance Claim Forms

Configure different health insurance claim forms for various claim processing scenarios in a web-based health insurance claims management software.

  • Graphical form builder available via both mobile and desktop web browsers
  • Processing of various health insurance claim forms in a single environment with classification
  • A set of form fields that is easily customizable to your requirements without coding
  • Changes to claim forms during health insurance claim management process execution
  • Claims data export to MS Word and MS Excel
Health Insurance Claim Forms  Health Insurance Claim Forms

Claim Processing Transparency and Compliance

The health insurance claims management software ensures automatic validation of data and transparent claim processing.

  • Transparent view of the entire health insurance claims process — from initial notification to claims disposition and settlement
  • Regulatory and SLA compliance
  • Fraud and compliance management
  • Data and document centralization
  • Reports on efficiency of claims management process overall or for individual claims
Claim Processing Transparency and Compliance  Claim Processing Transparency and Compliance

Powerful and easy health insurance claims management software you were seeking. Risk-free trial!

Health care and Health Insurance Challenges

The Affordable Care Act (ACA) addressed the issue of health care for the uninsured in US and made difference for nation’s health care industry. But other challenges remain actual on our way to a healthier world. Future legislation changes and efforts of both health care providers and insurers should address such challenges as innovation promotion and making health care more affordable.

At CMW Lab, we have a long history of working together with insurers to welcome innovation into health insurance business operations, boost process effectivity and make health care more affordable.

You may be interested in our other services: business process automation tools and business process management software.

Powerful and easy health insurance claims management software you were seeking. Risk-free trial!

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