Claims Exception Workspace

Claims Exception Workspace

Your healthcare claims platform is excellent at auto-adjudication. It may even automate the process of prioritizing, triaging, and reducing pended and exception claims.

Industry standards indicate about 80% of claims are seamlessly auto-adjudicated, while 20% still require hands-on review, and your claims platform quickly flags those cases as exceptions. Then what happens?

Where do your claims exceptions go?

  • Are you using spreadsheets with macros
  • Are you relying on email alerts and manual workarounds
  • Do the exceptions drag down Service Level Agreements

To overcome these challenges, we built Claims Exception Workspace, one of the first accelerators built on the Healthcare and Life Sciences Service Management Core.

CEW is a NextGen digital claims resolution solution that easily integrates with your core claims system through the ServiceNow Integration Hub, providing visibility into the entire claims exception lifecycle.

With CEW, resources across the enterprise easily engage and collaborate in claims exception resolution, providing visibility for management and reducing cost per member per month.