News: Functionality is organizations’ top priority for claims management vendors, survey says
Healthcare organizations’ top priority when choosing vendors for their claims management is functionality, according to a recent report by KLAS. In a survey compiling claims management purchase decisions of healthcare organizations, 83% of respondents chose functionality as their main consideration. In a breakdown of functionality type, 55% said they value a solution that saves time and simplifies claims processing the most. The second most-valued at 50% was claims scrubbing, or full control over editing and customizing rules, followed by reporting/analytics that provide visibility into outcomes and denial prevention at 45%, HealthLeaders reported.
Data for the report was collected from 24 organizations’ claims management purchase decisions between February 2020 and November 2022. On the lower end of functionalities listed, provider credentialing and payer enrollments was chosen by 10%, notifications about payer updates by 10%, and coordination of benefits and real-time eligibility by 7%.
The second-most chosen priority by healthcare organizations was “other,” which included things like consolidation, expertise, reputation, road map, sales experience, and user experience. After that, organizations showed a preference for existing vendor relationship (46%), cost (42%), and integration (33%).
The report also showed overall performance scores for vendors based on customer respondents:
- Experian Health: 90.1
- Olive: 89.2
- Quadax: 88.0
- Waystar: 87.3
- SSI Group: 87.2
- Availity: 87.0
- FinThrive: 84.0
- Change Healthcare: 76.6
Editor’s note: To read HealthLeaders’ coverage of this topic, click here. To read the KLAS report, click here.