4. Data Interchange and Integration
It's been described as the lifeblood of an insurance company. Others prefer to call it the
"new oil". Whatever name you use, data is key for any successful claims management
system.
There is a direct link between data interchange and efficiency. Claims operations are
constantly hampered by system constraints and bottlenecks that impede the sharing of
information across the enterprise. Whether in paper or electronic formats, claims
organizations deal with a huge number of documents – insurance contracts, finance
documents, accident and medical reports, legal forms, invoices, payment vouchers, and
more.
The importance of effective data Interchange cannot be overstated. An effective claims
system should offer a centralized method for compiling and distributing claim information.
Increasingly, electronic data interchange (EDI) is playing a much larger role in the process,
allowing a timely and accurate electronic exchange of standardized data between different
companies.
Questions to Ask
What hosting model does the vendor offer: vendor-hosted or self-hosted or both?
Does the vendor have a history of successful SaaS implementations?
How does the vendor handle data privacy and security issues?
What back up functions and capabilities are in place?
What are your "exit" capabilities?
Does your organization have the infrastructure to handle a self-hosted model?
The ability to securely transmit data between internal departments and
external resources can effectively eliminate claim processing delays,
enhance workflows and expedite the resolution of claims for improved
claims service delivery.
CLAIMS BUYERS GUIDE | 6
