Transform Healthcare Pended-Claims Processing Prime Solutions
Healthcare claim exception handling resides on a spectrum of complexity, ranging from mismatched or duplicate information, to the newly defined and evolving practice of care management. As one of the world’s most regulated industries, U.S. Healthcare presents its stakeholders with an ever-growing list of challenges to growth. Cumbersome manual processes, mounting rules and regulations, rising healthcare costs and shrinking profit margins all work against desired outcomes.
Gaining ground will require improvements to those operational processes within an insurer’s control, especially the handling of data and documents in a way that allows the knowledge worker more focus on high-value work. Today’s healthcare provider must be nimble, intelligent and armed with the information for good decision-making on an enterprise-wide basis—an impossible task under most existing line-of-business systems.
Prime Solutions can bring about this organizational transformation, and it can do so without the cost of system replacement or the inefficiency of continuous retrofitting. By leveraging the data residing in current administrative systems and Appian, the low-code development platform, we replace fragmented systems and processes with a seamless, consolidated and comprehensive user experience.
In as few as 6 to 8 weeks, with one sprint after another, we can eliminate hundreds of manual medical claims processing operations, assigns incoming work to the right worker and keeps all information at the user’s fingertips within concise, simple-to-navigate user interfaces. Utility is immediate and ROI is beyond anything that similar products can claim.
In a climate of mounting complexity, the challenge to become more competitive at lower costs may seem an impossible one. With the intelligence of Appian and the hidden power of your existing line-of-business systems, Prime Solutions' clients realize the same gains that the top market competitors have…
- 99%+ claims paid within 30 days
- 95%+ claims paid within 7 days
- 1 day backlog of unprocessed claims
- 97%+ claims processing accuracy
- ROI in as little as 6-8 weeks
Contact us today!