Digital Healthcare Claims Automation
Healthcare payers are facing rising costs and an increased demand for services while having to bring customer experience into the 21st Century. A great claims experience is vital for payers and usually results in retained, and new, customers. A modern claims system goes beyond the automation of routine tasks. It places the customer at the centre with integrated communications, open access to important claim data, transparent decisions and fast claim turn around.
Claims transformation
Caseblocks provides claim templates and a standard process alongside a configurable rules engine to help you start automating claims quickly. We also recognise that insurance payers are all different in the detail of how processing happens and the technical environment in which claims are processed. That’s why we also provide tools for business-led configuration, technical customisation and integration to your existing policy data.
Benefits
A configured Caseblocks claims solution will address the following improvements:
- High levels of straight through processing through automation and integration
- Low turn-around time with automated claim assessment
- Contained benefit leakage with configured benefit calculations
- Enhanced levels of customer communication with email, keeping customers informed of required actions and claim outcomes
- Improved customer experience with Caseblocks data integrated to customer facing websites and mobile apps
Insurance Types
- Outpatient
- In-Patient
- Dental
- Maternity
- Pharmacy
- Pre Authorised
Features
- Preloaded claim templates for different claim types
- Standard claims process from capture through to settlement
- Configurable claims rules and automated assessing
- Referred claim handling
- Configurable insurance products with benefits and rules
- Scripting environment for detailed business logic and integration
- Integrated email with automated inbound routing
- Automated payment runs
- Rich media handling for video, images, documents and audio
- Network management
- Cloud or on-premise
