ClaimVantage Suite

The ClaimVantage Suite, offered by Majesco, is a claims management software designed to automate and streamline the claims process for insurance companies of various sizes. According to the vendor, this solution caters to professions and industries such as life and health insurance providers, property and casualty insurance providers, dental insurance providers, and vision insurance providers.

Key Features

Flexible, Simplified Claims: According to the vendor, the software automates and streamlines the claims process for a range of insurance products. It includes features such as eligibility checks, benefit applicability, claims summary, and post-submission claim form editing. The vendor claims that it supports insurance products like dental, life, vision, accident, long-term care, disability, critical illness, hospitalization, and more.

Advanced Claims Management: The vendor states that the software provides end-to-end claims management from intake to settlement and payment. It manages appeals, reopen claims, hold/release claims, void claims, resubmit claims, and archive claims efficiently. The software offers single-point-of-change functionality for effective discrepancy management. It includes a comprehensive 360-degree dashboard for each claim, allowing a unique cross-LOB claim view. Additionally, the vendor claims that it provides an event center to monitor claims timelines and action plans.

Exceptional Customer Experiences: According to the vendor, the software enables end-to-end, digitally-enabled claims handling for customers. It supports case-driven straight-through processing and exception workflow. The vendor states that it empowers claims adjusters with a highly configurable and business rules-driven platform, aiming to meet the evolving expectations of policyholders.

Case-Driven Management with Straight Through Processing: The vendor claims that the software automates and streamlines case management through always-on processing. It utilizes a flexible, simplified, STP-first, and automated claims operating environment. The software automates eligibility checks, benefit applicability, claims summary, and post-submission processes. It also configures workflows and tasks to optimize decision-making and reduce manual administrative duties. According to the vendor, it provides better insights for data-driven decisions.

Better Claims Outcomes: According to the vendor, the software utilizes built-in, rules-based best practices, workflows, and third-party integrations. It assigns claims to the right people at the right time to improve outcomes. The vendor claims that it improves the accuracy and timeliness of claim decisions. It manages discrepancies, monitors timelines, and creates action plans. The software also includes an event center to monitor claims timelines and action plans.