Insurance Claims Processing Case Management

Huge Impact on efficiency and profitability

Even though about 80% of incoming health claims are electronic, the remaining twenty percent are typically paper-based, and present health insurers with high volumes and high costs. Naviant can provide your organization with a solution that helps reduce costs in this area by 15% to 30%.

By integrating with core claims applications, OnBase Case Management is able to verify if coverage is in place and if the policy is active before distributing a claim to an assigned adjudicator.

With OnBase’s Advance Capture capabilities, claims forms may be identified and classified (automatically noting any duplicate claims), extracting line item data from claims forms such as UB04 and CMS1500, and converting the values to an XML data stream. This can then be imported directly into core applications to create an EDI file, eliminating costly data entry, improving process quality and reducing processing times.

With the OnBase Case Management Claims Processing Solution, insurers have identified the ability to significantly reduce headcount by more than 50% in data entry areas.