The following processes are part of Claims Management:
Auto Adjudication, which is a process that allows claims to be processed automatically without humanintervention, based on predefined rules and criteria. Auto adjudication can improve the efficiency and accuracy of claims processing and reduce operational costs.
Reserve Management, which is a process that involves estimating and setting aside funds for future claims payments. Reserve management can help insurers manage their cash flow and solvency and comply with regulatory requirements.
Payment, which is a process that involves disbursing funds to claimants or providers after a claim has been approved. Payment can involve different methods, such as check, electronic funds transfer, or debit card. Payment can affect the customer satisfaction and retention rate of insurers.
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