How do I have a backlog? Let me count the ways. Conversion, seasonal patterns, new business, and even the occasional lapse in attention because things had been going well. Claims-related issues start small and then suddenly are eating up hours of time, and you have a backlog on your hands. Whether it’s an issue created through plan build and benefit logic, network pricing, and workflow, or eligibility loading and maintenance, when claims don’t process correctly, it can start the beginning of a slow-down and then create a traffic jam in your process.
The challenge is you don’t always know what the catalyst for the backlog is. It is often up to you or your employees to act as archeologists, digging into history looking back in time at the claim data to find the source of the problem. Worst case scenario, you find yourselves running in place. Days go by and tracking numbers show no improvement, with more claims backing up.
But, what if it didn’t have to be this way? That’s where limited claims management comes in. Part psychic, part archaeologist.
Instead of waiting for the pile-up, JMS brings an SME with a proactive plan. Scheduled availability each week and focused effort troubleshooting claim-related issues timelier is going to alleviate and even prevent the pileup. These are the most common culprits:
- Plan build issues
- Network issues
- Provider issues
- Eligibility issues
Think of it as personalized, dedicated office hours for your system and team. That special JMS someone to work through processing pain points and discover how best to optimize your workflow with your software.
In addition, limited claims management can offer an assessment of practices pinpointing inefficiencies or system issues that can make processing claims easier in the future. Not only is JMS there to help you improve your system today, but we’re also a trusty resource to ensure a better system and process tomorrow.
Limited claim management brings efficiency and ease to help the platform do what it was meant to.