Healthcare insurance claims processing is the administrative and financial system that facilitates the submission, assessment, and payment of medical claims for healthcare services provided to individuals by healthcare providers, such as doctors, hospitals, and clinics. It is a crucial component of the healthcare industry and plays a significant role in ensuring that healthcare providers are reimbursed for the services they render. Read this presentation to know more.

1. Health Insurance
Claims Processing
With RPA
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Understanding Healthcare Insurance Claims Processing
Healthcare insurance claims processing is the
administrative and financial system that
facilitates the submission, assessment, and
payment of medical claims for healthcare
services provided to individuals by healthcare
providers, such as doctors, hospitals, and
clinics. It is a crucial component of the
healthcare industry and plays a significant role
in ensuring that healthcare providers are
reimbursed for the services they render.
As per a report, around 52% of individuals
have insurance claims, both personal and
at the workplace.

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Challenges with Manual Healthcare Insurance Claims
1. Manual
Data Entry
2. Complex Rules &
Regulations
3. Communication
Delays
4. High
Administrative Cost
With high volume claims request
received, healthcare providers
struggles to handle the large amount
of data to verify and initiate
payment. Some of the common
challenges that healthcare providers
struggle with-

4. © 2023 AutomationEdge. All rights reserved. Value Led Hyperautomation
Automation in Healthcare Insurance Claims
RPA offers advantages to healthcare
providers in streamlining the
healthcare insurance claims by taking
over the repetitive tasks like claims
data extraction, verification and
imitating claims payment
autonomously. Some of the benefits
that RPA bring to the table for
healthcare providers are-
1. Simplified Claims
Intake
2. Improved Claims
Adjudication
3. Prevention of
Fraud
4. Intelligent Claim
Routing
5. Data
Reconciliation
6. Customer
Interaction

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