FINEOS Provider is an integrated approach to claims and provider management that incorporates key benefits of FINEOS Claims and FINEOS Payments to simplify the complicated and matrixed approach to provider management required in today’s complex market.
Why do you need Provider Management Software
Provider management software is essential for insurance companies to manage their provider networks efficiently, streamline claims processing, and improve the overall quality of care for their members. It can help reduce administrative burdens, improve accuracy, and reduce costs, leading to improved profitability and better customer satisfaction.
Provider Management Software Capabilities
- Register and manage provider records: credentials; services and fees; payment preferences
- Capture and automatically review / pay invoices
- Collaborate with providers at case level
- Rehab planning
- Provision providers with self-service capabilities
- Conduct analysis by service type, commencing with the largest medical treatment types by cost to the scheme, to identify the extent of over-servicing and establish more thorough clinical guidelines
- Develop case management frameworks based on best practices to ensure that cases are handled in a consistent, high quality fashion
- Embed procedures and systems for early identification of aberrant provider behavior
- Eliminate manual processing and reduce process cycle times / cost
Benefits of Provider Management Software
- Unified claim financials
- Providers fully integrated to claims process
- Lower TCO for all parties
Customer Case Study: New York Life Group Benefit Solutions - Core Administration System Total Digital Transformation
New York Life Group Benefit Solutions teams are empowered to focus on customers instead of systems administration ...
FINEOS Provider Management Software – Frequently Asked Questions
What is provider management software?
A provider management software like FINEOS Provider is a comprehensive provider administration and management software solution designed specifically for the unique needs of the life, annuities and health insurance industry.
What are the key features of provider management software?
Provider management software is used to register and manage provider records and collaborate with providers at case level to improve patient outcomes. FINEOS Provider management software also uses a robust search engine with comprehensive access to provider, payment and claim information. Case management frameworks within provider allow cases to be handled in a consistent, high quality manner.
Does FINEOS Provider management integrate with claims management and payments management?
Yes, FINEOS Provider integrates with FINEOS Claims management and FINEOS Payments management which enables collaboration and improved communication between case workers and service providers.
How does provider management software reduce external claims management expenses?
Provider management software like FINEOS Provider leverages provider information and analytics to negotiate lower rates, conduct analysis by service type and cost to identify over-servicing and prevent fraud with early identification of abnormalities in practice patterns.
What modernized technology can you find in a provider management solution?
FINEOS provider management software uses an open core system with greater flexibility across different platforms. It is designed for the B2B2C model in life, accident, health, group, voluntary and individual insurance markets.
How does a provder management solution improve operational efficiency and effectiveness?
A provider management solution reduces time and costs associated with service inquiries and requires less time tracking information. FINEOS Provider uses robust automated reconciliations and prevents duplication of provider information through online validity.
How does integration with claims management and payments management benefit the provider management software?
Integration of claims management and payment information provides more sophisticated analysis which leads to better contract negotiation, cost reduction and fraud prevention. Manage claim expenses through analysis of provider practice patterns. Integration also enables invoices and payments to be accurately aligned with service contracts.