Claims Processing

Claims processing focuses on prompt customer service, so timing is crucial. The goal is to reduce customer service inquires, facilitate communication between representatives and departments, and resolve the claim as quickly as possible.

Claims processing and claims administration is very paper intensive and has a large number of supporting documents that may be associated with a claim all coming from a variety of sources. This paper must be handled by different resources and may require comparison of records generated via paper, fax, email and/or electronic files. This type of manual paper solution is difficult to audit and challenging for reporting purposes.

Highly distributed environments where branch offices receive claims but the processing is handled at a central location, are even more challenging. Prompt-payment regulations also increase the importance of fast and efficient claims processing.

Consequentially, many other challenges arise with this substantial amount of information; such as how to effectively collaborate, secure, distribute, duplicate, share, store, retrieve, and potentially destroy these business critical documents.

Another organizational challenge presented to processing claims is how to reduce the cost of operations, when many insurance firms are located in expensive real estate locations. Why waste money on expensive office space filled with filing cabinets? What if thousands of files could be reduced to a few gigabytes of space for electronic storage and you used the office space for people not paper?

Workers processing Healthcare Claims, Insurance Claims, Damage Claims, etc. can benefit from an environment where all information can be accessed from a single source; instead of chasing down physical and electronic records distributed around the enterprise and within a variety of repositories. Claims processing software as part of Enterprise Content Management (ECM), specifically document management with workflow, is an ideal solution for these challenges.

At KnowledgeLake, we deliver document capture and imaging solutions designed for these claims processing and claims administration challenges. Our industry-leading Enterprise Content Management (ECM) software takes the hassle out of paperwork and provides a lower cost of ownership and higher return on investment than the competition. With our help, you will spend less time chasing paper and more time doing what you do best; serving people. The KnowledgeLake claims processing software solution provides organizations administering claims with fast, easy scanning of paper and the capture of electronic documents; along with sophisticated indexing of these documents for faster search and retrieval. The easy-to-understand SharePoint interface minimizes training, and easily integrates with most line-of-business systems, enabling document imaging for applications where it was otherwise unavailable or cost-prohibitive. You can share, distribute and collaborate across diverse applications, business processes, and platforms.

KnowledgeLake ECM solutions increase productivity between staff, associates, and clients. They can reduce or eliminate time-consuming duplicate data entry and routing of information. Once paper has been converted to digitally formatted information, typically by scanning the paper, it can be handled much faster and more efficiently. Documents and transactions can be linked by key metadata tags and then automatically routed based on business rules placed upon the values held within the document.

The process of capturing the data can be even more optimized with features such as Optical Character Recognition (OCR), data validation, and database index lookups. Integration with backend systems, front-end systems, and database repositories can help match and auto-populate key metadata fields and triggers. These validation and automation steps reduce data entry errors and enhance accuracy and processing efficiencies.

The routing of information around the organization via an automated electronic workflow can eliminate paperwork delays, and enable staff to easily track files through their process lifecycle. Companies can streamline operations and deliver better client services through more efficient business flow processes. Subsequently, this increases productivity, reduces cost, and achieves regulatory compliance when dealing with your insurance claims, healthcare claims, managed care claims or any other claims your organization processes.

KnowledgeLake has helped hundreds of organizations do more with less by streamlining document-intensive, back-office routines.

Working with your staff, KnowledgeLake can help deploy a solution that results in:

• Faster Collaboration and decision making with easy access to key documents. Enable local and remote access to documents allowing staff to work from home or the field rather than late nights at the office.
• Improved Customer Service - expedites administrative processes, shortening the time needed to make decisions from months and weeks to just hours. Customer inquiries regarding case status can be answered more accurately and quickly, reducing traditional delays associated with file search and retrieval.
• Immediate Processing of Files - documents move through the system more efficiently.
• Achieving government environmental mandates by reducing the need for paper.
• Proof of compliance with legal requirements via reporting, discovery requests and audit trails.
• Reduced operating costs associated with labor, printing, mailing, data entry and more.
• Line of Business Integration that enables users to immediately retrieve supporting documents from various proprietary and legacy applications.
• Shared secured information for staff and associates with concurrent access to content. Ability to collaborate on documents improves the efficiency of all processes and enhanced electronic security protects client privacy.
• Faster user adoption that results from the intuitive SharePoint interface.
• Redaction or encryption technologies protect selective pages and portions of PDF and TIFF files, allowing only specific users to view various areas within a document.

Microsoft-Centric Solutions

KnowledgeLake’s ECM software for Microsoft SharePoint enables you to organize unstructured content and store it in SharePoint. This tight integration of KnowledgeLake products with SharePoint enhances your existing technology investment through:

• Low cost of entry and ownership by leveraging existing Microsoft IT investments.
• Leveraging your existing scanning investments including scanners, copies (MFP) and fax devices.
• Meta-data driven searches that provide fast search capabilities to maximize employee productivity.
• Total Enterprise Content Management with SharePoint that lets users scan, index, search, view and manage content.
• Browser experience of SharePoint for document management, records management, and web content management.