Healthcare Payer Product
Why Healthcare Payer Solutions
As a payer of health plans and insurance, your goal is as much to remain profitable as it is to service customers' needs. Quick TAT for claims handling coupled with accuracy and process control of some of your essential buying needs, and spiraling cost of health care necessitate effective management of health claims.
To top these challenges, HIPAA and other government regulatory requirements demand a need for efficient systems, technology and business processes.
Challenges
- Healthcare payers manage huge number of subscribers, usually in millions.
- Claims need to be processed with quick turn-around.
- Subscriber records need to be accurate, up-to-date and verified before claims adjudication.
- Complicated payer reimbursement processes.
- Rising costs for providing healt care.
- High processing cost Regulatory systems (HIPAA, EDI).
Healthcare Payer Market Scenario
- The US Healthcare Market alone is worth more than $2.8 trillion.
- Costs of healthcare benefits are increasing by 15-18% year-on-year.
- Payors face high level of manual processing and administrative costs: For every $1 spent in the payer market, over 24%+ is spent on administrative costs.
- Legacy technology solutions are difficult to integrate with other platforms and conversion to new technologies with automated capabilities is a cost challenge.
- Payors experience cost containment pressures in order to drive higher profitability.
i-Claim Recommended
i-Claim is a platform-based suite of services enabling healthcare payers handle their end-to-end claims processing life-cycle.
i-Claim Advantages
With i-Claim you will experience...
- Unmatched quality – guaranteed 99.5% and above in data capture.
- World's fastest pre-adjudication performance.
- Complete compliance with regulatory norms (EDI & HIPAA).
- Increased ROI from automation.
- Best-shore delivery model.
Other healthcare products and services from Datamatics
- Healthcare Provider Services
- Healthcare Payer Solutions
- Healthcare Payer Services
- Charitable Organization Solutions
For more information on the above solutions and services, please write to healthcare@datamaticstech.com.
