Why Use a Document Management System for Claims Processing?

Insurance companies are just as incentivized as any other enterprise environment to “go paperless.” Content management and electronic document processing solutions address many short-term and long-range problems the insurance industry is going to have to tackle. 

The number of Americans with access to health insurance has shot up, according to U.S. Department of Health and Human Services (HHS) data, mainly due to improved access. With home ownership spiking during the COVID-19 pandemic, that also means more policies, more claims, and generally more paperwork for underwriters, claims adjusters, and more.

How can a document management system improve and streamline claims processing for your organization? 

Document Management Systems Introduce New Efficiencies 

The future is entirely digital. The pandemic introduced remote work for all types of professionals. More and more healthcare support staff are working remotely, and they need encrypted interfaces from which they can access patient and healthcare records.

With those workers doing more and more from home, like making appointments, verifying coverage, and so forth, they will also expect improved information flow from insurance providers. Electronic document-based workflows can provide that convenience, as well as improve customer satisfaction and your overall ROI. 

With more and more challenges facing hiring managers, you also need as much flexibility as possible to empower remote workers and staff. Digitizing workflows creates opportunities for new hires to process claims, file paperwork, and engage with customers from any internet-connected device. 

Improved Compliance and Security 

Insurance agents and managers are equally concerned about compliance, and rightly so. By working with an electronic document management system that’s already satisfied regulatory hurdles, your system will likewise meet your HIPAA obligations.

Permission-based, fully encrypted document management systems are typically easier and more cost-effective to secure than physical files and repositories. You can, for example, immediately revoke permissions for former employees, as well as broaden or narrow access rules for new hires. Digital intake systems are almost always more secure than a paperwork-heavy file process. 

Electronic document repositories and file systems also improve redundancy. Modern SaaS (cloud) platforms include automatic backup and storage systems, ensuring that your documentation is safe from loss or physical damage. 

Better Audit Functionality and Record Retention

Electronic document management systems allow for better record-level tagging and search functionality. Improving digital record keeping means that audits (once the stuff of storage boxes and manual “search and find” processes) can become almost completely automated. 

Additionally, those tagging functions help your team automate record retention schedules. Empowering the team with automated reports provides “at a glance” status of various document cycles and follows logic-based functionality based on your team’s needs. 

By automating your claims process, you can also:

• Reduce claims cycle periods
• Easily search and find a claim
• Confirm status of a claim faster
• Search by meta-level information (date, name, etc.)
• Better report and analyze claim response periods based on numerous factors (classification, resolution, approval, rejection, etc.)

Reduce Errors and Costly Fines

Speaking of audits, most audit issues and complaints arise due to missing or incorrect information in a claim or a record. If there’s one thing that a computer can do better than a human, it’s scan a document for missing/required information. 

Claims processing is complex and requires multiple steps. If a claim is complete from step one, not only does it mean fewer regulatory issues, it also means the claim gets processed correctly the first time. Automation and workflow improvements simply reduce the reliance on human intervention. When you invest in systems that simply do a better job of processing information than a person ever could, you not only cut down on mistakes and errors, you also increase your overall ROI. 

Summing Up

All paperwork-heavy industries can benefit from centralized, digitized, streamlined document management systems. Working with a partner familiar with the particular needs of insurance and healthcare further empowers your team to improve customer relations, as well as attract and retain a more digitally inclined workforce. 

Even if you’re burdened with an out-of-date legacy system, the professionals at QFlow can work with you to improve and update your system. We have the experience and knowledge base to transition your documentation from the old system to your new system, as well as recommend taxonomies and digital workflows that will improve the lifecycle and security of your document and claims repositories. 

QFlow Systems helps:

• Organize and digitize your paper-heavy processes
• Store and tag electronic content so it shows up easily in any search
• Identify, improve, and streamline workflows 

We set up your end-to-end document management system from design and implementation to training your team. Our ongoing support keeps your systems running smoothly, working with you to make sure your staff and stakeholders have the tools they need well into the future. 

Need to find out more about QFlow’s records management solutions? Click here to schedule your free consultation.