Claims Processing

Welcome to the Pile

Claims Processing - Mahwah, Manhattan, New Jersey

Are your claim volumes growing? Are you finding it harder to process your claims with your existing staff? Is it becoming more difficult to meet performance goals?

The industry will experience steady growth over the next five years, as the growing senior population creates demand via Medicare. Furthermore, the number of insured individuals will rise in line with healthcare reform, as people with preexisting conditions are able to receive insurance. The growing senior population will keep driving demand for the industry’s services over the next five years.

  • The percentage of premiums paid out in claims are estimated to be between 60% and 110% of premiums.
  • Current processing costs are estimated to range between 3% and 12% of premiums.
  • Manual data entry exposes insurance companies to higher claims processing costs and corporate risk.

The Doc I Group Claims Processing Solution integrates with core claims applications. With our advanced capture capabilities, claims forms may be identified and classified automatically, extracting line item data from claims forms and converting the values to an XML data stream or 837 EDI File Format.

Our solution eliminates costly data entry, thereby improving process quality and reducing processing times. As a result, insurers have identified the ability to significantly reduce headcount by more than 50 percent in data entry areas. The Doc I Group provides customer-facing employees, agents, brokers, adjusters, and service organizations with a powerful scan-to-process platform that automatically:

  • Captures claim related data from any paper or electronic document.
  • Classifies and extracts the appropriate information.
  • Validates and routes content where required.
  • Initiates straight-through data processing and business decisions based on insurance-specific rules and knowledge bases.
  • Provides status updates and alerts to claimants, offering a higher degree of communication and responsiveness.

By scanning at the front end, the DIG Claims Processing solution enables insurance carriers to integrate field resources, agents, brokers, and third-party service organizations into the claims process. This increases data accuracy and quality, closes the information gap between disparate departments, processes, and functions, and dramatically enhances information availability throughout the organization.

Contact us for a demonstration today!