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"Improving the claims adjudication process for payers"

With time and money at a premium for today’s providers, going the extra mile to provide much-needed support will improve the provider-payer relationship.

From eligibility verification to remittance, claims adjudication remains notoriously slow, inefficient and expensive due the persistence of manual processes. Prior authorization and document attachment, in particular, continue to rely largely on phone calls, emails and paper faxes. This leads to a buildup of unstructured documents; the need to scan and save information can lead to delays that last weeks (or even months) and prevents providers from getting paid quickly. 

Clearly, there is room for improvement. Payers and providers who can automate data collection and improve data integrity will be well-positioned to optimize claims adjudication. As a result, providers will receive their authorizations – and their payments – faster. With time and money at a premium for today’s providers, going the extra mile to provide much-needed support will improve the provider-payer relationship.

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