Claim Management
Automated Software For Processing Of Claims
- We have an automated operating system for tracking our claim assigned.
- At each level , a push notification email is sent to Insurance company official email notifying the stage the claim is currently in.
- Automated reports are generated from the system to find critical information to the Insurance companies like Pharmacy bills duplications/ Pathologist association with other hospitals etc.
- The internal system intimates the used as per levels assigned (Case‐Allotment, Updates, Medical Summarizer) via push messages within the defined TAT for each level.
- TAT is raised as an alert to the users so that claim is not missed from the system.
Powerful software to track and manage fraud investigations and report on results for better risk management and prevention.
Claims Investigation Assignments Include
- Customized Management & Operational Reports.
- Electronic Reports, Photographs & Attachments.
- Field Investigation Time.
- Online Management of Assignment Details.
- Professional Case Management.
- Professional Reports.
Intake & Assignment
Easy Case Creation
Cases can be assigned to investigators automatically, based on preset criteria, or manually by an investigation manager or supervisor.
Streamlined Fraud Investigations - Logical Workflow
Conduct better fraud investigations with logical workflow rules that keep investigations on track and ensure nothing falls through the cracks. Every step is tracked and recorded in the centralized case file for easy collaboration and reporting.
Quick Case Summaries - One-click Investigation Reports
Create professional case reports with the click of a mouse. There’s no need to gather information from multiple documents and files. All the relevant information already entered in the case file is filtered into a pre-formatted Word document that can be shared automatically or sent by email.
Fraud Prevention - Manage Risk
Get the information you need to manage fraud risk and implement fraud prevention and program integrity programs. By studying trends and analyzing investigation data, your team gains an understanding of vulnerabilities and areas that need improvement.
Investigate On The Go - Mobile Friendly
Claimscart’s mobile-friendly interface ensures investigators can access case files from anywhere with an internet connection, saving travel time and providing real-time status updates to stakeholders.
Teamwork - Collaborate With Others
Collaborate with other team members in real time. Each team member can be granted access to case information based on their assigned role.