Medical Claims Management Solutions Market Growth Rate, Market Volume and Forecast Report

A medical claim is a detailed invoice that a health care provider sends to the health insurer, exactly showing the services that have been rendered by the providers to the patient. Medical claims management involves multiple administrative and customer service layers that include review, investigation, adjustment, remittance or denial of a claim. Improved focus on quality healthcare services and adoption of cloud technology related services are contributing to the growth of the medical claims management solutions market. Medical claims management solutions generally aim at attaining complete automation of processing of claims, faster access to customer information without negotiating on the security of private medical information. However, insurance claim 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. Automation helps in reducing costs associated with processing of claims, utilizing a single platform for all data sources, workflows for routing claims for review and approval processes, increasing the uniformity of payments, and timely payment of claims. According to the National Health Insurer Report Card published in 2011 by American Medical Association (AMA), around $17 billion a year (on an average) could be saved by eliminating errors in claims. Automation reduces the paper storage and document retrieval costs while complying with regulatory standards such as Health Insurance Portability and Accountability Act (HIPAA). Health insurance payers invest in their claims management systems to gain interoperability and faster release of new insurance claims, in addition to, improving efficiency of claims processing.

However, the Asia-Pacific is expected to witness the fastest growth during the forecast period (2017-2023). The factors driving this growth include increasing geriatric population and improved healthcare infrastructure in the region. In addition, the government initiatives to spread awareness about the benefits of this technology among the general population have also contributed to the medical claims management solutions market in this region. Therefore, the demand for healthcare IT solutions in the region is expected to increase significantly during the forecast period.

The major players in the medical claims management solutions market include IBM Corporation, Cerner Corporation, Oracle Corporation, Avaya Inc., Genpact Limited, Cognizant Technology Solutions Corporation, Accenture PLC, Allscripts Healthcare Solutions, Inc., Athenahealth Inc., Aspect Software Inc., and Infor Inc.

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