Why EOB Automation is the Key to Long-Term Success

EOB automation

Your Service Matters — But Are You Doing It as Effectively as Possible?

As a third-party administrator, you perform an incredibly valuable function. You take a significant workload off the plates of brokers, employers, and plan participants alike. Your EOB processing service ensures that plan participants get reimbursed for medical claims in a timely fashion — especially during crunch times like the end of the year. But year-end isn’t the only time speed and efficiency matter. All year, participants can be submitting claims to your company, and those individuals are just as motivated to get those claims wrapped up as you and your team are. 

Despite the joint sense of urgency to get medical claims substantiated and reimbursed, healthcare administration is no easy task. In fact, it’s one of the leading inefficiencies in the American healthcare system as a whole. So how can you as a TPA step up to plan members’ need for a speedy process (which is also important for your business) while trying to navigate the complex processes and requirements of a massive industry that’s in a state of peak inefficiency?

The answer is simple to state yet difficult to truly implement. It’s automation — and for your business particularly, it’s EOB automation. It’s easy to state because anywhere you look, you’ll find a number of resources spelling out the benefits of automation for a variety of industries. Some are more advanced and specific than others. Some are utilizing robots while others are still building our software solutions as a first step. 

For TPAs, inefficiency stands at a more granular level — in our day-to-day communications and workflow. Claims specialists and other TPA employees have to manage a large influx of information each and every day. To some, emails and spreadsheets are just part of doing business. Sure, it might not be the most efficient way to work, but even if you’re using Cloud-based productivity tools and communications at your business, you’re still wasting time and losing revenue. 

Why? Because you — and plan participants — shouldn’t have to deal with it at all. That’s where EOB automation comes in. As the American population continues to age, the workload TPAs will only continue to increase. Now is the time to make a change, and with EOB automation, it’s faster and easier than you think. 

5 Ways EOB Automation Can Help Your Business

1. It Helps You Win the Numbers Game

This one’s simple. The more claims you’re able to process for plan participants, the more revenue you gain. Using EOB automation, you accomplish more faster — thus creating the capacity for additional opportunity.

2. It Helps to Reduce Inefficiency 

We all hear the word everywhere, but when it comes to plan members getting reimbursed, employers being satisfied with you and their brokers, and your brokers continuing to use your company in new relationships, it makes all the difference. EOB automation gets rid of the manual processes that have been holding you back. 

3. It Improves Internal Communication and Processes

Plan participants, employers, and brokers aren’t the only ones that can get frustrated with slow EOB processing. Your team can, too. Imagine having to do the same tasks repeatedly, countless times per day. It can get difficult. And while some hands-on will still be required, eliminating redundant tasks from your team’s plate improves their productivity and helps to prevent burnout. 

4. It Strengthens Relationships

Remember, for TPAs, relationships matter. Doing your work well is the key to success across the board. You can’t make everyone happy, but if an employer starts hearing about slow claims reimbursement or trouble submitting claims one too many times, you can be sure your broker will hear about it, too. EOB automation keeps your valuable service running smoothly, quickly, and with as little involvement from the participant as possible. 

5. It’s Just Good Business

Your company is not a cog stuck in an ever-grinding machine with nowhere to go. You’re a business, and whether you’re the one who owns it, leads it, or works claims, growth is important. With EOB automation, you effectively push the roadblocks aside so your company can focus on adding more clients, processing more claims, hiring the right people, and achieving your long-term goals.. 

6. It’s Your #1 Sales Strategy Tool

When a broker introduces you to a new employer, both want to know that you’re going to step up to the plate for their participants. They want to know that you’re able to keep up and that you have systems in place to meet participants’ needs quickly and efficiently. EOB automation is your solution to these barriers of entry into a new relationship. 

7. It Reduces Your Costs

If you were to manually process EOBs and other business functions, you’d need more people, more office equipment and software licenses, and more time. Each of these costs your business money (and not an insignificant amount, either). Multiplied by the number of employees and claims involved, and you’ve got some serious administrative costs that are standing between you and revenue. 

One Last Thing…

It’s important to not automate a bad process. If one of your internal processes is a consistent bottleneck or causes your workflow to come off the rails, it needs to be fixed first. Otherwise, you’ll simply be making an inefficient system good at being inefficient.

Get an EOB Automation Platform Built to Make Life Easier

At TPA Stream, we’ve built an industry-leading EOB automation platform that not only streamlines EOB automation but also extends its usefulness into numerous other areas. Our platform uses plan participants’ own insurance logins to get the information you need immediately, process it, and route it into your benefits administration system. 

Furthermore, we work hand-in-hand with every one of our TPA clients, analyzing their current processes to ensure that our platform synergistically enhances your workflow from the very start of our relationship.

Ready to learn more about TPA Stream and our integration options? Get a demo today. 

Why TPA Stream

TPA Stream is a thriving, innovative insurance technology company committed to empowering better benefits by connecting systems, transforming data, and helping TPAs unlock more revenue.

Learn more about TPA Stream here.

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