Home » Articles » Introduction to claims processing outsourcing

Introduction to claims processing outsourcing

Introduction to claims processing outsourcing

Claims processing outsourcing (CPO) is a relatively new business model for insurance companies. This emerged as the preferred alternative for organizations that are looking to reduce their operating costs and improve their service levels. 

If you’re new to this business model, you may be wondering what exactly claims processing outsourcing is. Here’s a quick overview of this operation.

Claims processing definition

Claims processing refers to the process where an insurance company checks the authenticity, justification, and further information for a client’s insurance claims. It starts when a healthcare provider submits a claim request to the insurance company.

If proven valid and up to the client’s insurance package, then the provider can reimburse the money in whole or in part.

Otherwise, the company can deny the claim if it is proven to be invalid, duplicated, forged, or outside the scope of their insurance contract.

Claims processing definition

What is claims processing outsourcing?

First coined by the International Association of Insurance Supervisors (IAIS), claims processing outsourcing is the method of transferring the handling and verification process of insurance claims to third-party service providers. 

Get 3 free quotes 3,000+ BPO SUPPLIERS

This is commonly used by companies who need to manage a large volume of claim requests that require a significant number of resources — both human and technology.

In simple terms, if you have a lot of claims to go through, an outsourcing provider can help you make a dent in your workload and finish all insurance claims on time.

What is claims processing outsourcing?

Benefits of claims processing outsourcing

Claims processing is an integral part of an insurance firm’s operations. However, it is also a tedious process that can take a lot of time.

There are many reasons for you to outsource your claims processing services. Here are some:

Stress-free process

Outsourcing provides a hassle-free and stress-free process. It also promises a faster turnaround of the insurance claiming process, avoiding delays and long wait times for claimants.

Improves customer experience

Client-facing businesses have a lot on their plate. People rely on your company to deliver fast and professional services while also taking the time to listen and support them on their needs.

Claims processing outsourcing teams can give a human touch to your services. Because their focus is only on fielding and processing insurance claims, you are assured that a fast response is being given to customers with an improved customer experience.

Get the complete toolkit, free

With this setup, clients become more satisfied with your services, preventing reports and escalations. 

High success rate

Outsourcing agencies have dedicated teams for their claims processing services. With their help, you can avoid frequent repetitions and promise clients a one-time processing success.

They are also equipped with the knowledge of how to process insurance requests in a fast, efficient, and accurate manner. Their highly-trained team of professionals will ensure that the claim is processed effectively.

Benefits of claims processing outsourcing

Cost-efficient

Insurance claims need a lot of time and resources to be fully processed. Outsourcing companies already have a team of insurers at their disposal. With their assistance, the company can avoid hiring additional in-house staff to finish the task.

Moreover, because service providers come with their own tools and equipment, you do not have to spend money on additional office space, computers, software, and other overhead costs needed to finish all claims.

All you need to provide is the compilation of clients and claims needed to be processed, and you are good to go!

Productivity increase

Just like other functions that you can outsource to an external team, claims processing outsourcing frees up the time of your local team. It enables them to focus on their own roles and responsibilities within the company. 

Additionally, delegating the bulk of claim requests to an outsourcing partner gives you the space to prioritize other areas of your business. 

With more extra time on hand, you can point your in-house staff’s attention to other core parts of your organization.

Claims processing outsourcing in the Philippines

Outsourcing your insurance claims is a win-win situation for both the outsourcing provider and your company. It is also beneficial to you as an employer since it gives you access to more skilled and experienced workers.

Filipino workers are known for their hardworking nature and a positive attitude towards work. They also have a good grasp of the English language, which is essential in order to communicate with your customers.

Their personality traits also make them good candidates for the job. They are known to be patient, friendly, and courteous towards customers.

Further, the Philippines has a large pool of qualified workers, with many companies offering claims processing, so you have a lot of options to choose from. 

If you are interested in contracting the help of Filipino claims processing teams, you can start shopping around and compare prices before making a final decision.

Get Inside Outsourcing

An insider's view on why remote and offshore staffing is radically changing the future of work.

Order now

Start your
journey today

  • Independent
  • Secure
  • Transparent

About OA

Outsource Accelerator is the trusted source of independent information, advisory and expert implementation of Business Process Outsourcing (BPO).

The #1 outsourcing authority

Outsource Accelerator offers the world’s leading aggregator marketplace for outsourcing. It specifically provides the conduit between world-leading outsourcing suppliers and the businesses – clients – across the globe.

The Outsource Accelerator website has over 5,000 articles, 350+ podcast episodes, and a comprehensive directory with 3,000+ BPO companies… all designed to make it easier for clients to learn about – and engage with – outsourcing.

About Derek Gallimore

Derek Gallimore has been in business for 20 years, outsourcing for over eight years, and has been living in Manila (the heart of global outsourcing) since 2014. Derek is the founder and CEO of Outsource Accelerator, and is regarded as a leading expert on all things outsourcing.