How to Evaluate the Right Claims Management System for Your Organization?

With continuous changes to the code business, Claims Management Systems (CM) have evolved with technology. These systems area unit equipped with newer capabilities to produce increased services to customers. In such things, evaluating and choosing the correct CM for your organization may be a troublesome task. so as to help with this method, we tend to furnish a couple of easy steps through that you’ll assess and opt for the correct CM for your organization.

Check the potency and responsiveness of the system:


• Claim management systems area unit crucial to creating the purchasers glad and to enhance the general performance of the corporate. A CM ought to be ready to manage the whole claim method – from the start to the ultimate settlement. The code ought to facilitate in organizing each file activity and maintain reports.


• additionally to performance, a CM must enable the user to run reports instantly. the power to quickly access data can expedite the claims, permitting staff to come to figure, and employers to avoid wasting valuable resources.

• A group action – accessing and saving a claim, making letters, etc. mustn’t take over ten seconds, and on a median it ought to be done solely during a few seconds.

• whereas evaluating the performance and reaction time of the CM, guarantee to ascertain them during a real time setting with and user information. this may provides a complete image of the performance and also the responsiveness of the system.

Technology employed in the system

Today, several organizations like browser based mostly systems that facilitate them alter preparation, support, and permit for remote access.

• whereas evaluating the technology, check the kind of info being employed. it’s vital to settle on the correct info with an easy and economical information model. this may facilitate produce reports and information mine severally.

• A important issue that goes unbridled by several organizations is with relevancy the news info. The news info ought to be unbroken cut loose the transnational info because it impacts the system performance.

Security, confidentiality and hosting model of the system

Security and confidentiality of the information

It is the responsibility of the organization to stay the claimants data secure. so as to stay the information safe, it’s to be encrypted with construction access passwords. All users ought to tend distinctive ID’s and passwords with no plain text.

• To reset the countersign and shield system security, don’t enable viewing of the recent countersign.

• information to the user and from the user ought to be encrypted employing a SSL encoding. along side this, user access permissions, levels of authority, hierarchy, etc. – area unit necessary to confirm security and confidentiality.


• If your organization possesses adequate information measure and infrastructure for supporting new applications you will wish to contemplate hosting the system.

• If not, hiring a good net host is you best different. make certain to verify the system is often accessible and is supported with none interruptions within the services. in addition, in selecting an online host ensure that there’s instrumentation redundancy and document backup to confirm information is replicated with none loss.

Functionality and options of the system


• for each CM, there ought to be some basic useful modules like claim/claimant maintenance, notepads, diaries, reporting, payment and reserves, etc.

• Check the practicality that may facilitate the examiners to target closing claims quickly. you’ll raise varied queries relating to the practicality of the CM, reckoning on your business necessities and work flow.


• Check the options of the system and every one the information classes that your organization wants.

• The system ought to alter users to create information fields because the organization grows and risks become a lot of advanced.

• Check for the code integration. this provides the new capabilities in sinking the claims quickly and expeditiously.

Vendor assessment

Once the system meets all the specified tips, it’s necessary to assess the seller. so as to assess a merchant, many factors ought to be thought-about.

Clients’ wants

• AN economical merchant ought to perpetually work on rising the system, supported consumer wants. they ought to be to debate new practicality and any challenges with implementing system enhancements. raise any potential merchant however usually they meet their purchasers for discussing such problems.

Other factors (past expertise, etc.)

• take into account vendors past expertise. however economical they area unit in analysis and development of latest technologies? however effective are they’re in data transfer?

• References would assist in selecting the correct net host. this may offer applicable insight to what a relationship with the seller are going to be like within the future.

Pricing structure

• rating structure ought to be versatile for every consumer. reckoning on size and wish, every contract will vary greatly. Terms of payment ought to even be versatile so as to permit corporations of all sizes to seek out a system that works for them financially. A CM with several users ought to price less per user than that of 1 with fewer users.

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