Leading claims processing practices use disciplined approaches and innovative techniques to increase accuracy and decrease cycle times, resulting in lower administrative costs and appropriate medical costs.
How we can help you
The PricewaterhouseCoopers team of experienced professionals can conduct a claims operations management assessment, which includes:
- Root cause analysis from a people, process, data and technology perspective
- Review of audit reports from employer groups and departments of insurance, metrics, policies, process maps, training manuals and other departmental information
- Work observations to assess the relationship between practice and procedure
- Process mapping of current adjudication and upstream functional interface
- Review of performance management systems and reported system-related issues
