Employers and insurance companies have to deal with the responsibility of handling health insurance administration on top of their usual daily duties. Managing a business is hard enough without sorting through claims. The in-depth process can be a drain on the resources within your company’s human resources department. Instead, try hiring a third-party medical claims management solution to evaluate claims and decide whether they have merit. Here’s some information on what they can do for you.
What Claim Management Services Are
You can hire an individual administrator or opt for a claims management firm. Firms are especially helpful in that they can handle a variety of duties at once, saving you time and money. Many agencies have the ability to focus on everything there is to know about health insurance plans from eligibility requirements to claims processing. Regulations and laws change every year, so having the services of a professional firm that stay ahead of the changes that can affect your health insurance and risk management is imperative.
Many businesses conserve available worker resources by assigning all of their health benefit-related activities to a third party claims management solution. They might even set aside a specific fund through which administrators can pay health claims after processing the claim. It’s the administrator’s job to review the claims and compare them to the patient’s insurance policy. If the claim is valid – the administrator works with the insurance company to pay the policyholder.
Why You Should Outsource
Managing employee benefit plans or health policies can be a complex and time-consuming duty. This is why many insurance companies outsource the task to a third party. Hiring a third party administrator can also cut a company’s operating costs and improve profitability because you don’t have to pay an in-house team. Some insurance companies may hire claim management services to process claims from start to finish. This can include taking on all processing tasks including collecting premiums, handling new enrollments and handling customer correspondence dealing with plan changes or account statuses. Other claim services deal strictly with determining the worth of a claim. You may also find it useful to hire a company that specializes in your industry or the type of benefits you provide. Third party specialists can make medical claims including workers compensation claims much simpler.
If you are an employer or health insurance company, sorting through claims can be a long and tedious process. Instead, reap the benefits of partnering with an expert and seasoned claims management team, saving yourself both money and frustration.
Contact Action Claims Administrators today to to learn more about our nationwide TPA services.
We are Dedicated to Excellence in Claims Administration!