The global Healthcare Claims Management market is anticipated to grow at a CAGR of 5.2% during the forecast period (2024-2031). As the global population grows and ages, the number of people seeking healthcare services is also increasing. Hence the market demand for better and improved system is rising and market players are focusing on introducing new software in the market. For instance, In April 2023, Google Cloud announced a new AI-enabled Claims Acceleration Suite that streamlines health insurance prior authorization and claims processing. The solution, leveraging the newly created Claims Data Activator, will help health plans and providers reduce administrative burdens and costs by converting unstructured data into structured data, enabling experts to make faster, more informed decisions that improve patient care. AI-enabled prior authorization is available to Google Cloud customers, and other features of the Claims Acceleration Suite will be available soon. The current prior authorization process takes 10 days on average, according to the Centers for Medicare & Medicaid Services (CMS). During this process, healthcare providers check the benefit coverage of their patients to see if prior authorization is required for a recommended procedure, medication or device, and submit the supporting information required.

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Healthcare denials are becoming increasingly common, as payers are becoming more scrutiny of claims, according to a report KFF health, In May 2023, Millions of Americans in the past few years have run into this experience, filing a health care insurance claim that once might have been paid immediately but instead is just as quickly denied. If the experience and the insurer’s explanation often seem arbitrary and absurd, that might be because companies appear increasingly likely to employ computer algorithms or people with little relevant experience to issue rapid-fire denials of claims sometimes bundles at a time without reviewing the patient’s medical chart.

Global Healthcare Claims Management Market Report Segment

By Component

Software
Services

By Type

Integrated Solutions
Standalone Solutions

By Delivery Mode

On-premise
Cloud-based

By End User

Healthcare Payers
Healthcare Providers

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Company Profiles

Accenture plc.
CareCloud
Cognizant Technology Solutions Corp
Conifer Health Solutions
eClinicalWorks
Genpact Limited
Kareo
McKesson Corp
Optum, Inc

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