Claims Integration: A Growing Must-Have for Voluntary Benefits

Of the few silver linings of the pandemic, none has been as transformative as group insurers’ efforts to upgrade their platforms with modern core systems. With advanced core technology, insurers can enhance digital self-service and also support the workflow automation tools needed for a smoother claims experience, in particular claims integration, a growing must-have for voluntary benefits insurers.

Through an integrated claims process, voluntary benefits customers can receive their claims payment with minimal effort, due to system-based models that retrieve and analyze claims data. As a result, customers can instead focus on their rehabilitation and recovery. As the voluntary benefits industry attempts to make inroads into consumer benefits, promoting the value of claims integration can also increase consumer awareness and the perceived value of voluntary benefits overall.

Claims integration allows customers to fully access and use the inherent value in voluntary benefits products while providing a smoother claims experience.

Voluntary benefits carriers can also profit from claims integration functionality. Variable expenses per claim should decrease dramatically, as less human intervention is involved with claims adjudication. However, Health Insurance Portability and Accountability Act (HIPAA) privacy concerns remain the elephant in the room. As medical records can only be released with the consent of the individual or a guardian, carriers must have the appropriate documentation and permission. In addition, unless the carrier is offering medical and voluntary benefits under the same legal entity, it may be more difficult and time-consuming for a voluntary benefits carrier to obtain the necessary information to automatically process and pay claims. Employees also have lingering privacy concerns – only 35% are opting into claims integration for automated claims when given the option during enrollment.

Another issue is that to develop an effective claims integration process, carriers need the proper infrastructure. It may be more effective for carriers to use consultants to facilitate claims integration, medical record code interpretation, mappings, and claims processing algorithms.

Claims integration allows customers to fully access and use the inherent value in voluntary benefits products while providing a smoother claims experience. This growing must-have technology can potentially boost awareness of these offerings and increase customer satisfaction and long-term customer loyalty to ultimately attract more purchasers.

To see how we can transform insurance administration through claims integration and other enterprise capabilities, while providing an effortless digital user experience, click here.

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