Exception claims handling is a health insurer’s most manually-intensive line-of-business operation. Reliance on inefficient operations makes quick response and accurate processing even more difficult. Insurers need a solution that brings necessary capabilities – Business Process Management, Enterprise Content Management, Business Rules, Analytics and Collaboration – to exception claims handling, but without the costly replacement of the existing business systems. IPD’s Ultera® for Healthcare Claim Exceptions is that solution. An out-of-the-box application delivering a robust set of content, process and case-management capabilities, Ultera® automates manual operations, unifies disparate processes and systems and presents knowledge workers with clear, intuitive user interfaces for managing and collaborating on exception claims.

Ultera® for Healthcare Claim Exceptions provides…

  • Rules to drive decisions and workflows
  • More efficient workflow and content configurability
  • Modern user interfaces that enhance the usability of existing line-of-business systems
  • Straight-through processing for selected tasks or entire claims
  • Reporting and dashboards
  • Easy-to-access audit trails and information consolidation for at-a-glance decision making
  • User interfaces specifically designed to meet claims handling needs
  • Distribution and management of work
  • Industry-leading Content Management