BLOGS
Improve Customer Experience and Gain Efficiency with Claims Processing Software
November 9, 2023 by Mark Oja

The importance of satisfactory customer experience is so important that it can jeopardize the entire operation if not handled properly. As a TPA or Claims Payor, you have the unique distinction of having to service three distinct but related entities : Groups, Members, and the Providers

There will be efficiency and growth in the operation only when all three parties are satisfied with the customer experience that the TPA provides. The TPA and the claims software they use brings all these parties together to create a cohesive ecosystem where all the parties work together to deliver quality patient care and streamlined insurance claims payment experience.

However, due to the increasing pressure in the industry, it is getting even more challenging to maintain the satisfaction levels needed to stay competitive for both Groups,Providers,and Members.By utilizing the features in the ClaimScape claims processing software system, TPAs and claims payors can achieve this goal and maintain customer satisfaction levels, promote growth, and lower costs.

Simplify your Claims Process

TPAs lose revenue when their claims process is too complicated and requires too many people and resources to be involved in each claim. Valuable time is lost and SLAs are not maintained whichagitates members and customer service deteriorates. DataGenix ClaimScape claims processing software simplifies the claims settlement process by automating necessary tasks that do not need human intervention such as automated claims processing and benefits processing and customer communications.

Transparency is always Knowing

These days, providers and members expect instant results, and they do not want to be kept in the dark. With ClaimScape, Members and Provider are kept up to date with automated reminders and correspondence by email and SMS and the on line web portal allow patients and provided to check status, get an ID Card or EOB copy , send a message , download forms , or submit claims 24/7. Every step in the process from preapproval to claims payment can be tracked by Members and Providers

Standardization means Simplicity

Standardized claims processing helps make the process quick and efficient. It enables payors to provide better customer experience by decreasing response times to customers and providers.When the entire process is simple and standardized, it also makes it easy to train staff to use the software to provide a positive customer experience

Security is more Valuable than Gold

The web is wrought with endless cyber threats from both private and government-based actors attempting to disrupt operations. ClaimScape Cloud-based solutions utilizing the ultra-secure and highly available AWS platform assures security and reliability every step of the way. Encryption at rest and in transit and multiple layers of security, including two factor authentication, and 24/7 monitoring assure security of critical data

Communication is the Cornerstone

The customer always wants to be well informed. ClaimScape customer service capabilities utilize SMS and email notifications to notify members and provider of status along with simple customer service call center tracking. A customer that feels he is being ‘heard’ and well informed is satisfied customer. ClaimScape call reporting helps identify trends and issues so that the customer experience is always being improved.

These attributes , when used effectively with ClaimScape claims platform will create a streamlined and efficient claims paying organizations

These attributes , when used effectively with ClaimScape claims platform will create a streamlined and efficient claims paying organizations