Outsourcing & Insourcing: A Healthier Mixture for Insurance Claims Management

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November, 2018

Every business industry is under tremendous pressure whether to handle the tasks in-house or outsource or go for a hybrid approach. Today with the changing market trends, this move has become turmoil for businesses and the insurance sector is not excluded from this phenomenon. However, the answer is not simply black or white!

If we consider the claims management process – a tedious and labor-intensive task, it blurs the lines between insourcing and outsourcing. In general, there is no need to outsource claims management process if, and only if, an organization have a good infrastructure and established in-house team to perform the task better internally with better quality and minimal price. This is actually a stumbling block in many organizations.

In the claims dome, countless processes can be handled in a number of ways. Some insurers who handle the claims process internally got good results, and some got great opportunities. However, other insurers prefer outsourcing services for their end-to-end process, and you may find modifications in results. Looking at the variety of approaches, it seems the best result will occur when insurers embrace “all of the above” approach.

By analyzing both internal proficiencies with external niche skills, insurers with the craving for an innovative end-to-end claims management services are likely to see both- high quality and best endings.

So let’s take a look at the benefits that can be reaped from this type of multi-channel claims management approach:

Reduced operational cost-

From the traditional viewpoint, outsourcing often meant employing business partners out of the country as an approach for manufacturers to reduce costs while refining quality. But today, much of the outsourcing companies are in the US, especially as it relates to the insurance claims processing.

 For instance, an insurance company in Montana receives five claims per month. So what you think, does it put some logic to staff in-house team from different geographic regions with poor results? Is it not a smarter way to gain benefits of hiring an independent assistant in your geographic area, enabling you to focus on your internal staff with higher claims counts? By utilizing an appropriate external team, insurers can radically reduce their overall expenses.

Improved efficiencies-

See every business wants steadiness, and efficient processes and insurance business is not an exception in this regards. More so, claims management is one of the important operations for insurers as it entirely impacts the reputation of the company. Now you think for a while, your in-house adjusters seriously have this much time to analyze each medical bill or review a CPT coding manual for future services? It’s obviously no! Therefore, hiring an external claims team who can precisely look after each document can help your adjusters to settle claims faster, which ultimately increases your client satisfaction ratio.

What happens next? You’ll observe efficiency throughout your claims lifecycle as identifying productiveness is the excellent component to the long-term success of your insurance carrier. There will be a tremendous improvement in the overall productivity of your in-house team and adjusters.

Domain experts-

Typically, the most challenging job for every insurer or any other business owner is finding niche expertise. Possibly, the chances are higher in the insurance industry as for claims processing they have seen aging workforce retiring faster than being substituted. This is actually threatening the insurers as many organizations are moving towards new business models that emphasize on productivity at the cost of necessary claims competency.

Well, you can attain this business model by embracing the outsourcing model. How? Outsourcing firms have skilled and experienced niche expertise that deliver quality and accurate claims management services, freeing up the insurer’s time so that they can focus on what they do best!

For example, subrogation cases are where claims have a hard time. With the help of the external skilled team, insurers can easily uplift their recoveries rate while reducing expenses.

Growing technology-

According to researchers, there are three key routes to success- processes, people and technology. Don’t get confused with technology because many entrepreneurs think that embracing new tools is the only solution. However, technology is used as a crucial tool to enhance both people and processes efficiently. In the case of basic claims investigation, technology can help claim adjusters in making viable decisions about coverage and outstanding amount. Technology also addresses the common issues that include inadequate understanding of the concept of liability, stop you from taking shortcuts and help you negotiate on fundamentals.

Enhanced management-

Once your claims management process gets streamlined, being an insurer, you can stay focused on your core competencies that include encouraging underwriters, policy management, tracking commissions, etc. This eventually impacts the management of the insurance carriers as they can focus on formulating new policies for the sake of business growth.

Bottom Line

Making the right decision can be daunting; however, above-mentioned benefits may help you up to a certain extent. Try to define your business goals and evaluate the need for insourcing and outsourcing back office services with your team.

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Avneet
At Insurance Support World, Avneet heads up the social media function and holds the designation Global Marketing Manager. She manages all activities related to social media across the company, from blogging to marketing, customer support to internal communications, and much more. You can follow ISW on Google+.

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