Reasons to Integrate Healthcare Claims Management

Reasons to Integrate Healthcare Claims Management

Every healthcare organization has its own way of practicing the patient-centric approach but they all share the same concept of depending on analytics and technology. Modern healthcare is strongly reliant on data and the ability to share and benefit from big data in enhancing clinical decisions and trials. On the other hand, healthcare systems are facing a lot of challenges trying to harmonize analytics, integrated data, and information platforms. Healthcare experts suggest that the best way to get through modern health challenges is by having incident reporting and claims management functionalities working seamlessly on one platform.

The Importance of Healthcare Claim Management

Medical claims management depends on patient diagnoses, treatments, and medications for billing, filing, updating, and processing of medical claims. The issue is that maintaining patient records, interacting with health insurance agencies, and issuing invoices for medical services are time-consuming responsibilities.

Effective claims management is important for patients to know what they owe and medical facilities wouldn't be able to receive funds in exchange for patient services.

Benefits of Integrating Healthcare Claims Management

• Efficiency & Accuracy

Imagine how simple would it be if you were working with one insurer instead of several! The same rule applies to integrating healthcare incident reporting and healthcare administrations into one system instead of tracking each in different systems. Yet, unlike insurance where it's impossible to receive multiple coverages from the same insurer, hospitals are able to integrate claim data and incident data easily through healthcare risk management software.

Healthcare risk experts believe that having data in one system adds convenience because it saves them the trouble of toggling between systems to keep up with the claim lifecycle. The truth is that the need to switch between multiple software systems to find the needed information for a specific claim is just time-consuming therefore, it's important to have all data in one spot to reduce this quest for data.

Moving into the costs! Shifting between two systems causes detrimental switch expenses, we are talking about the fractions of seconds that occur when moving between systems, these switch costs rapidly gather resulting in wasted time and increased errors.

By using an integrated healthcare risk management system, you won't need to bounce throughout the claim lifecycle.

• Improved Communication & Accountability

Integrating incident reports and claims data in one system improves communication and coordination between employees and departments as well. Moreover, having the needed information just a click away helps risk managers process claims more efficiently while granting them extra time to spend doing higher-level work.

In addition to simplifying the claims process, the accessibility afforded by an integrated system can actually motivate employees.

Having all healthcare data integrated into one system also allows for streamlined workflow automation.

Our need for automation or a system is to trigger early critical steps in the process that can be delayed or missed, thus impacting the overall claim severity.

Finally, the automated workflow includes the assignment process, allowing the user to track how long claim resolution is taking.

• Healthcare analytics development

An integrated healthcare risk management system gathers data from all incidents and claims throughout the system. With healthcare analytics, this aggregated data can be used for specifying goals and making strategic decisions, taking the claims process to a whole new level. When data is calculated in separate systems, users may miss the key parts of the underlying report. Or, users may spend extended time trying to compile volumes of data through unrepeatable processes. Regardless, these efforts can lead to data errors, missing information, or outdated data sets—all of which increase the potential for missed opportunities in the risk decision-making process.

When data is calculated in the same system, users gain a good view of their role in the claims process. For example, those in healthcare claims management roles can access incident reports to see what’s driving the majority of claims, providing valuable context for how the team can easily process claims and understand the conditions.

NANO Health's healthcare risk management system features extraordinary dashboard templates. These templates can be customized to fit an organization’s specific needs, ensuring that the data being collected and analyzed is telling meaningful stories and delivering insight needed for organizational change.

Furthermore, an integrated system allows healthcare organizations to see if the strategies they chose are truly driving change. The same reports and dashboard functionality can be used to monitor such progress. A central repository of data, along with the built-in healthcare analytics tools required to make it meaningful, help to create the real, lasting change hospitals and healthcare systems need.

NANO IMS

Our NANO IMS (Insurance Management System) is a fully blended web-based insurance management solution to administer and execute the work processes for insurance businesses and third-party administrators; it improves modularization allowing the diverse departments to interact and meet their requirements and desires for maximum functionality and usability. Moreover, our innovative and comprehensive Insurance Management System is designed to minimize cost and maximize patient health and positive outcomes. The new era of insurance management has just started!