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The newly released version 6.2.4. of EIS Group’s (San Francisco) ClaimCore system supports multiple lines of group and voluntary benefits insurance and enables insurers to improve claims accuracy and efficiency, streamline payment processing, improve compliance and enhance fraud detection, according to the vendor. The ClaimCore solution has been designed to be deployed as a standalone core system or as a key component of the vendor’s modular EIS Core Insurance Suite, providing benefits insurers with additional options for transforming their legacy core systems.
“Group and voluntary carriers are increasingly looking to invest in technology replacement plans to free them of their legacy system constraints,” comments Rob McIsaac, SVP, Research and Consulting, at Boston-based research and advisory firm Novarica. “Rather than pursuing wholesale conversion of monolithic existing platforms, we see some carriers starting with underwriting, billing and claims as logical starting points on a measured multi-year journey. With the addition of ClaimCore for the benefits market, EIS Group expands the options available to carriers as they extend their transformation plans for dealing with legacy technology platforms and the associated processes that they support.”
The latest version of ClaimCore increases automation of critical claims tasks and leverages enhanced workflow, work queues, rules, notes and document generation and management capabilities to deliver automated and auditable claims processes for the benefits industry across multiple lines of business, EIS Group reports.
Access without Integration Burden
When ClaimCore is deployed as part of the EIS Suite—which comprises the PolicyCore, BillingCore, ClaimCore and CustomerCore componets—eligibility and customer information are immediately available to claims operations without the integration burdens resulting from multiple vendor solutions, the vendor asserts. In addition, the common database and data model in the EIS Suite platform provides a single source of truth with data entered one time and leveraged throughout the entire customer lifecycle, according to EIS Group.
“The benefits claims functionality now available in ClaimCore allows our clients to manage and adjudicate claims in an efficient, accurate manner that increases satisfaction for customers and improves visibility and coordination for the carrier while delivering better claims outcomes,” comments Jim Eva, EIS Group’s product executive for claims.