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Claims: a good pay-off area, predicts F&S

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CIOL Bureau
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LONDON, INDIA: The adoption of claims management solutions is increasing, while creating a sizeable potential market for the next four to five years," notes Frost & Sullivan Research Analyst Jayapradha T E. "There exists a tremendous scope and opportunity for insurance claims management vendors able to provide competitive claims handling and processing."

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Insurance carriers of all sizes and type are looking to accelerate claims settlements, fight fraud, retain customers, improve underwriting by effectively analyzing data, manage litigation and streamline workflows in the insurance and healthcare industry.

New analysis from Frost & Sullivan, European Market for Insurance Claims Management in Healthcare, finds that multi-million dollar opportunities are emerging for a broad range of services. The market will experience considerable expansion as the concept of claims handling and processing changes and the insurance industry accelerates the development of such solutions to create a complete wealth management solution.

Consequently, there are significant opportunities for insurance claims management in the healthcare industry. However, insurance claims payers and providers need to be convinced about the need for these solutions and also the benefits of investing in them despite their sizeable cost. Claims management modalities vendors should focus primarily on providing a cost-benefit paradigm to users by offering optimal technology, quality and customer value. Vendors with such an offering would be able to capture the market.

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"The constantly evolving healthcare insurance industry is highly competitive. This situation supports insurance claims management solutions that offer high performance, low-cost claims processing and handling that meet the specific requirements of customers.

The processing of healthcare reimbursements in many parts of Europe falls under the under the purview of the public sector. As reimbursement systems and funding bodies vary across Europe, there is little incentive to develop payer IT solutions that support reduced reimbursement turnaround times.

"The dominance of legacy systems and the high price of insurance claims management solutions also affect market prospects," Jayapradha adds in the press release. "These solutions are relatively more expensive for claims payers and providers and can attenuate sales."

With global trends focused on enhancing revenue cycles, vendors are looking at improving administrative processes and adopting cost-curbing measures. Scalable systems architecture, quantifiable benefits to business processes and justifiable return on investment are other factors that systems vendors should incorporate.