For many hospitals, the Patient Insurance Claim process can be slow and fraught with delays. Submission errors are a time-consuming and costly occurrence, resulting in an increased workload for both hospital administrators and insurers. Missing documents or incorrect information submitted with patient insurance claims can cause payment delays and claim rejections, adversely affecting the cash-flow of the entire hospital.
The SoftCo E-Claims Solution
The SoftCo E-Claims Solution increases the efficiency of the entire Claims Process by streamlining the collation of claim data across the various departments and systems within a hospital. The solution handles multiple formats of claim information, from paper based claim forms to electronic records, fed directly from Hospital Information systems (HIS). Distributed capture capabilities allow various departments to add supporting documents such as invoices directly to claim records at any stage of the process. Once a claim is collated, the SoftCo E-Claims solution enables claims departments to automatically validate claim data against an intelligent rules engine to ensure accuracy and reduce claim pends/rejections from insurers. Validated claims can then be submitted directly to insurers in a defined electronic format, with the potential to significantly reduce payment cycles. The SoftCo E-Claims solution is built on the proven and compliant SoftCo R8 platform.
SoftCo E-Claims integrates directly with HIS systems to ensure that all patient claim information is accurate and up-to-date. The solution can be implemented in a phased approach to minimise disruption to day-to-day hospital processes, ultimately allowing claims to be submitted to insurers electronically, but also reducing internal claim processing times and facilitating the swift resolution of any issues that arise. SoftCo E-Claims provides claims departments with full visibility of the entire claims process, allowing individual claims to be escalated, while ensuring that bottlenecks are easily identified and removed from the end-to-end claims process.
E-Claims can be delivered on-premise or via SoftCo Cloud
Key Benefits:
- Improved payment cycles & reduced debtor days
- Streamlined claims collation process
- Improved visibility and control
- Minimal disruption to hospital operations
- Improved accuracy of submitted claims
- Supports multiple data formats (Paper and electronic)
- Secure and compliant data storage
- Integrated into HIS systems
- Instant access to documents for query resolution.
- Built on industry proven SoftCo R8 platform