Automated Medical Claims Processing

Reduce operating and administrative costs with an automated medical claims processing solution that provides flexibility and rapid deployment for changes while complying with the Health Insurance Portability and Accountability Act.

Client Challenges Today

Even in today’s hi-tech world, a significant volume of health and bodily injury claims are processed manually. Insurers are finding it increasingly difficult to process large volumes of claims in a timely and efficient manner. Health organizations and insurance companies need an automated medical claims processing system that is easy to implement and maintain, cost-effective and customer-service friendly.

Solution and How We Work

Capgemini’s Automated Medical Claims Processing solution receives medical claims transactions from first notice of loss systems and sends the approved bill information to payment systems. Our straight-through processing-based solution automates the bill adjudication and review and approval process for medical and bodily injury claims. The technology agnostic solution is extensible to non-medical bills as well such as glass, rental, property repair or replacement.

Why Capgemini?

Our Automated Medical Claims Processing solution:
Complies with the Health Insurance Portability and Accountability Act (HIPAA).
Provides rapid deployment of changes and offers a design conducive to long-term technology refreshment.
Reduces operating and administrative costs, including development and back-end data center operations.
Contact us

Contact us today at or connect with one of our experts.

Powiązane treści

World InsurTech Report 2020

The World InsurTech Report 2020 from Capgemini and Efma explores the changing business dynamics of the insurance industry – from the global pandemic underscoring the need for business resilience to BigTechs setting new standards for customer experience. The report highlights the need for insurers to adopt a new mindset and collaborate with ecosystem partners to innovate and build new capabilities that meet the digital needs of customers.