Let ActiveClaim by Genus Technologies accelerate and improve the medical claims process, enhance workforce performance, AND deliver data to measure your success
The next wave of digital transformation has arrived. Technologies like artificial intelligence and robotic process automation (RPA) offer insurers the promise of improving highly repetitive, low expertise tasks like medical claims processing. Done right, these technologies can also create real opportunities to improve the bottom line, increase employee performance and engagement, and provide precise data measurements of those efforts.
Getting it right can mean the difference between success and failure for those on the frontline of medical claims processing. There, tight regulatory deadlines, increasing workloads—and workforce shortages—all combine to threaten profitability. ActiveClaim by Genus helps insurers overcome those challenges. A customizable, full adjudication solution, ActiveClaim conquers the day-to-day problems involved in processing CMS 1500 and UB04 forms while delivering significant big picture business benefits, including:
- Improved full cycle claims processing and process documentation
- Better employee performance, utilization, and engagement
- Improved measurement data
ActiveClaim by Genus: Smart Solution, Big Benefits
ActiveClaim by Genus uses ingestion, classification, and extraction technologies and RPA innovations to increase the overall percentage of no-touch medical claims processing. But ActiveClaim goes a step further with customizable, digitized workflows that allow the quick identification, resolution and/or adjudication of exclusions. This means:
1. Improved full cycle claim processing and process documentation
“No-touch” is the gold standard of automated claims processing—and ActiveClaim has improved how exclusion-free forms flow through its touch-free system. But exclusions do come up, and ActiveClaim anticipates then fixes those problems.
ActiveClaim uses customizable workflows that quickly identify and separate “fast-fix” exclusion matters from those requiring more complex escalation and adjudication decisions. Then—even better--it and allows those managing the process to assign determination and resolution of the matter to the employee with the right skillset for processing.
Quick-fix issues get promptly returned to the automated process. More complex problems requiring coordination with other company departments surface faster. And, in addition to expediting processing, ActiveClaim lets insurers formalize (and assess possible improvements to) previously undocumented processes. The result? Faster claims processing time and more explicit overall process steps result in decreased processing cost with increased processing quality.
2. Better employee performance, utilization, and engagement
ActiveClaim also offers the opportunity to increase the efficiency of employees processing medical claims. By moving routine and tedious tasks to automated processes, ActiveClaim lets employees pay attention to more challenging issues and drive innovation. This kind of matching of employee ability to task does more than increase job satisfaction; it also helps create a high-performance culture and helps find and keep future company leaders.
Furthermore, the real-time feedback ActiveClaim provides on performance creates opportunities to interact more often with employees. Providing ongoing performance management information is increasingly important, especially to the millennial workforce. Helping employees understand their strengths and continuously develop new skills with ongoing, data-driven insights also increases engagement, and that, in turn, increases retention.
3. Improved measurement data
ActiveClaim provides worker-specific activity data that allows insight into workforce performance and ability. With ActiveClaim, insurers can monitor quality metrics to assess task readiness, match employee capability to task, manage problems, and identify emerging talent. Making sure employees are appropriately assigned increases utilization and aligns workforce costs. In other words, ActiveClaim helps those in medical claims processing match the right job to the right person—which also leads to greater output quality, employee job satisfaction, as well as workforce stability and retention.
By addressing the full adjudication cycle for processing medical claims forms, ActiveClaim helps insurers overcome process and performance challenges and serves as a solution that delivers a high return on investment and a better bottom line.