Health Care Facility | Insurers | Related Initiatives  

Claim Management

About this section

We’ve organized this section as a learning module to guide you on the art of claim and claimant management in HCAI. We’ll cover the basics like setting up, searching for and deactivating claim and claimant records, but we’ll also get in-depth about matching records with OCFs and tips on how your organization can help streamline the process.

Who should review this module

You’ll find this module helpful if you are involved with:

  • Setting up new claim-claimant records
  • Transferring claimants to a different adjuster
  • OCF matching
  • Deactivating claim/claimant records

This module can also help clarify system functionality if you are:

  • Involved with setting up or managing claim-claimant feeds through our integration channels
  • An adjuster who wants to understand how OCFs are delivered to your worklist
  • A manager or supervisor interested in learning more about claims and claimants in HCAI

What you’ll learn

  • The concept and purpose of claim and claimant records in HCAI
  • How to set up and search for claim and claimant records in HCAI
  • Details on when and how to transfer claimants to another adjuster
  • The importance of deactivating old claim and claimant records
  • An overview of the matching process
  • Tips on how your organization can reduce the number of documents received ‘Unmatched’

How to proceed with this module

We have organized this module into five logical steps: setting up claim and claimant records, searching for claim and claimant records, transferring claimants to a different adjuster, deactivating claim and claimant records and matching unmatched documents. For the best learning experience, we recommend that you follow these steps in this order

  • Setting up a New Claim and Claimant Record

    Explains how to set up a claim and claimant record in HCAI

  • Searching for Claim or Claimant Record

    Explains how to find the claim or claimant record

  • Matching Unmatched Documents

    Have no fear, this section will guide you on handling unmatched OCFs

  • Transferring Claimants to a Different Adjuster

    Outlines when and how to transfer claimants to another adjuster

  • Deactivating Claim and Claimant Records

    Examines why and how to deactivate a claim-claimant record