A1 Enterprise conducted a claims administration software demonstration for a rehabilitation and healthcare company, which has developed premier centers in multiple states in the US. As one of the largest healthcare services providers, they are looking for a claims solution that can help them streamline their process for risk management and claims process management.
There is no current standardized process for claims administration; claims are received in different formats from various sources. They need a claims administration system developed to help their customers easily submit claims and incidents in a uniform format from a singular point of source. In addition, they also need a reporting tool with visualization in a dashboard to identify facility claim trends and track status of claims handled by different teams.
Based on these requirements,during the demo, firstly the use of web-portals was presented which is developed separately from A1 Tracker for companies to use for data collection. A customized claim portal was presented as a key solution to standardize the claim entry process. A claim portal can be a single page or multiple pages claim form which gathers information about a claim where claimants or claim reporters can also upload files and additional documentation to support the claim. These portals are accessible not only through desktop computers but also through mobile devices. If a user requires mobile accessibility, the claim portal has the ability to allow Claim submission from any tablet or mobile device over a cellular network. Once claim details are submitted, the data is saved to the Claims Module of A1 Tracker, which will then allow the claims administration team to adjudicate, investigate, and follow up on the Claim centrally all within the A1 Tracker with ease.
Secondly, The claims management dashboard was also demonstrated as a data visualization reporting tool which offers reporting on specific periods that may coincide with fiscal years, loss run reporting from insurance carriers, and financial reporting MTD, QTD, and YTD. The claims dashboard allows managers to identify which claims require follow ups and action items. This also helps the company manage the workload and assignments for claim managers and adjusters. Such as, those who have less or more claims to manage and how to distribute the workload for processing claims. Another form of creating custom reporting is also available in A1 Tracker where each user can create filters & save custom reports and views based on what data they need to look at or export.
User Permissions restrict claim adjusters and users to allow access to specific claim records based on the business logic of a company such as restrictions can be made according to department, business unit or claim type. User permissions can also specify visibility of each claim field for different user groups. This level of granularity in security functions are governed by the system administrator and similarly can be adjusted based on the company security policy..
The claim process, business rules and workflow generate automated notifications, which is a great way to keep track of claims progress, notify team members of claim status changes, costs, or changes to reserves.
Additionally, in the demo A1 presented an email notification with embedded action smart button options , from which the recipient of that email can select whether to approve or reject that step in the Claims Process. This is followed by a sequence of notifications based on the appropriate action the recipient has taken by clicking on the button.
What is great about A1 Tracker is that it does not limit the company administrator from making changes within the system. The claims management software and workflow rules can be modified by the administrator according to their business needs, and the process may adapt over time as the claims management strategy changes or expands. A1 Tracker offers a centralized claims software system to standardize, automate, and streamline processing steps at every level.
A1 Enterprise offers this web-based system, as both a self-hosted and on-premise solution. To help companies optimize their time and modernize their operational software infrastructure, every implementation of A1 Tracker is configured to meet the different needs of the company. If you want to know more about how A1 tracker can help your business grow, optimize, and expand, click here to schedule a demo.