6 Key Benefits of Reporting in Claims Management

Successful benefits administration goes well beyond correctly and efficiently paying claims. Facts and figures have a way of affecting and addressing operational efficiency, and it’s essential for that data to be carefully gathered and marshaled across the entire claims system. Its success mandates an ability to interface with business partners, health care specialists, governmental entities, as well as your employees, members, brokers, and providers. Having access to the right information at the right time is critical for optimal management of your health plan, and ultimately, is the best way for you to support the health of the employees and families you serve.

We’ve built SpyGlass, our enterprise-class claims processing system, on a modern technology foundation to provide just that and more. The application contains a wide variety of powerful reporting tools to give you access to just the right information, including over 130 different standard reports for business operations and data analysis, an ad-hoc query reporting tool that supports customizable user-defined reports/extracts, and our Data Transformation Tools that allow access to over 1,000 different pieces of data within the system. Powerful modules like HIPAA Director, our all-in-one EDI gateway and scheduler, and our interface tools further allow you to access resources that help monitor and improve the wellbeing of your members while intelligently managing their cost of healthcare.

Reporting has become one of the most powerful aspects of claims management to both small and large healthcare payers alike. When properly utilized, it can provide the following key benefits:

Improve Productivity & Timeliness

When using an effective reporting module within your claims system, you enable your stakeholders to see key data and information in a timely manner. SpyGlass’s automated reporting capabilities take this a step further by allowing your reports to be sent out securely on a regular schedule. Beacon’s HIPAA Director gives you intelligent options for daily, weekly, monthly, quarterly, and annual runs, with intuitive sub-option settings for the “First Monday” or “Last Business Day,” along with precise one-time scheduling options. These flexible options let you integrate the secure, automated arrival of reports with the rhythm of your operation.

Increase Efficiency & Accuracy

Getting real-time data presented in clear, intelligent ways reduces your risks and allows you to make critical decisions based on accurate, reliable information. Since SpyGlass is all real-time, data becomes instantly available to all other parts of the application, including reports, as it is added to the system (via batch, manual entry, or third-party interface). SpyGlass provides most current available data at your disposal, allowing you to speed up your decision-making process.

Key reports can “slice and dice” and present multi-level data to you in one fell swoop. For instance, our Top Provider is designed to show you the top providers who appear on the most claims for your organization. Additionally, the reporting operation summarizes all the procedure codes and/or revenue codes being billed, along with the primary diagnosis codes that each provider is billing. You get top-level summary info, as well as tallied detail sorted and presented as you choose.

Leverage the Tools You Know & Love

Making changes to existing practices can be time-consuming. When your claims system integrates into your personal workflow and the tools that you and your team are already familiar with, you eliminate tedious manual tasks and workarounds. Beacon has integrated our reporting framework with Microsoft Excel to offer expanded, drill-down capability within report exports. Via a single click, SpyGlass reporting, search screen, or Data Transformation Tools exports enable the key features you need and want from a spreadsheet. You can utilize the full power of Excel to do any additional calculations on the output and capitalize on all the training you and your people have invested over the years pursuing solutions inside of Excel and Word.

Increase Your Range & Accessibility

Is the data you need readily available at your fingertips? Or do you often have to search through countless files and exports to find the information you’re looking for? SpyGlass not only takes the hassle out of this crucial process; it gives you the power to put your data at your fingertips.

For your users that need quick access to critical information, SpyGlass gives them over 50 different parameters that can be combined and selected from within our simplified ad-hoc report generator. These deliver intelligent sorting and sub-totals when you ask for them. Not only can ad-hoc reports be used for special, one-off queries, but users can save their custom reports/extracts with a unique name for easy reuse. For even more advanced reporting needs, our Data Transformation Tools function as extensive customizable reports that provide business users access to over 1,000 distinct data elements in over 30 meaningful categories.

Better Control

A good claims system has preventative measures designed to help limit access to your customers’ health care data and information. All of SpyGlass’s reports run through a reporting framework that allows them to be managed through our security controls and our standard SpyGlass presentation layer. Our comprehensive rules- and roles-based framework allows you to adjust report permissions by changing the user role of any users. This means that for each report, you can limit who has access to run the report.

Delivery options for your reports include secure network shares, secure FTP sites, or other transfer protocols with encryption. Every distinct transaction lets you specify exactly where you need your data delivered. Plus, you get notifications via email that give you critical transaction status info. You have precise control over which transactions send warnings or notifications, which helps to reduce the noise in your various inboxes.

Enhance Customer Focus

With more tools available to provide greater insight into your population, your management and account teams can be better equipped to anticipate the needs of customers. The system even helps you take preventative actions to enhance the health of the members and families covered. SpyGlass supports a system of health alerts or “triggers” for any number of user-defined criteria.

For instance, users can set up various triggers for conditions they want to monitor, like diabetes within your population based on a set of diagnosis codes, and run reports to get a detailed listing of claims that meet those conditions. Further, an incoming claim for an initial diagnosis of diabetes can trigger the sending of that alert to your wellness team to provide best-practice treatment information to the member. This goes far beyond mere reporting and can be useful for case management, analysis, wellness, and reinsurance purposes. These trigger reports are highly customizable, both in terms of what you can select to include as data for the report and also for what elements you’d like to include in the output of the reports.

Robust reporting is an essential function for any health plan with a need to share data findings around their organization. SpyGlass delivers all the options that can give you a competitive advantage. If you stick with your legacy system, you risk accepting unnecessary limits—older technology, limited ability to adapt, little access to data, no way to sort, sift, and filter, and no ability to use the tools that you have already mastered. Many of these challenges, however, simply require a new approach. With SpyGlass’s ability to provide immediate access to critical business data and analysis, your team will be ready to make thoughtful and informed decisions in order to grow your business and help run a smoother, tighter ship.

Ready to Learn More?

To see SpyGlass’s comprehensive reporting capabilities for yourself, register for a live, personalized demo with Beacon. Modernize your health claims management with Beacon’s leading-edge solutions.