Automated claims processing

Milliman Health ClaimsRef

Minimise errors, processing time and costs with rules-based technology-solution.

Milliman Health ClaimsRef

The challenge

Inconsistent claims processing increases cost and risk

Waste and inefficiency cost insurers billions of dollars each year. Without proven data structures and well-defined processes, excessive and unwarranted services go unchecked. However, claims processors face time limits on claim settlement, making it challenging to perform detailed analysis. Rapidly evolving medical practices and non-standardized claim codes further complicate their work.

The solution

Use rules-based technology to improve claims processing accuracy

Combining clinical knowledge and decades of experience across a wide range of projects, Milliman Health ClaimsRef applies configurable business rules to manage health claims accurately and efficiently. Data and learning from multiple geographies ensure that the rules are both evidence-based and locally relevant across most jurisdictions. Milliman Health ClaimsRef is easy to integrate with existing claim systems and can be used to automate claims processing.

Explore our guidelines

Supporting insurers, reinsurers and system integrators

How Health ClaimsRef can help

For system integrators

Optimize rules-based automation

Simplify and streamline digital practices in your region to support benchmarking and future analysis for clients. Our rules also help ease the integration process and avoid delays.

Benefits