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Cross-system claims coordination

Work that spans claims management, policy admin, billing, and email - where the handoffs are the bottleneck.

Claims management systemPolicy admin systemBilling systemEmailCustom internal tools
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How the workflow runs

5 steps
  1. 1

    Work starts

    Auto

    A claim, appeal, or payment enters the chain in system A

  2. 2

    Sync context

    Auto

    Status and context pushed to system B, C - the next person sees the full history

  3. 3

    Route handoff

    Auto

    Work routed to the right person in the right system with context attached

  4. 4

    Human checkpoint

    Human

    Person confirms before work moves to the next system - no blind handoffs

+ 1 more steps

4

Automated

1

Human review

5

Systems connected

The problem

Today this work is mostly manual. People move data between systems, chase approvals, and re-check things that should already be correct.

  • Claims that start in the claims system, continue in policy admin, and finish in the billing system
  • Handoffs that lose context - the next person has to re-read the entire claim file from scratch
  • Status updates that require checking three systems to know where a claim actually is
  • Approvals that cross system boundaries - and get stuck in the gaps between them

What we automate

The workflow handles the repetitive parts inside the systems you already use. No new tools to learn, no data to re-key.

  • Syncing status and context across systems as a claim moves through the chain
  • Routing work to the right person in the right system - with full context attached
  • Notifying stakeholders when status changes - without anyone checking manually
  • Compiling a unified view of where a claim, appeal, or payment stands across all systems

Before and after

Before
  • Claims that start in the claims system, continue in policy admin, and finish in the billing system
  • Handoffs that lose context - the next person has to re-read the entire claim file from scratch
  • Status updates that require checking three systems to know where a claim actually is
  • Approvals that cross system boundaries - and get stuck in the gaps between them
After
  • Handoffs that retain context - no more re-reading the claim file from scratch
  • Status visibility - one view of where a claim stands, across all systems
  • Fewer things stuck in the gaps - the workflow tracks work across boundaries
  • Your team has more time for decisions, not chasing status across systems

Where humans stay in the loop

Automation handles the repetitive work. Your people handle the decisions that matter. The line is agreed and signed before launch.

  • Decisions at handoff points - a person confirms before work moves to the next system
  • Approvals that cross system boundaries - routed through your existing chain, not bypassed
  • Exception handling - when a system is down or data does not match, a person steps in
  • Final sign-off - the workflow coordinates, your team decides