Claim management system provides management services to the customers. It involves payer and healthcare provider, wherein the process revolves around the fulfillment of the obligation by an insurer to receive, investigate, and act on a claim filed by an insured person. It involves multiple administrative and customer service layers that includes review, investigation, adjustment (if necessary), remittance or denial of the claim.
The claim management software comprises of modules for eligibility/enrollment, benefit administration, provider contracting and reimbursement, utilization management, premium billing, care management, claims processing, overpayment recovery, capitation, subrogation, customer service/contact management, fulfillment, reporting and more. A health insurance claim is a bill for health care services that a healthcare provider passes to insurance companies for payment. The bill is sent by the physician to an insurance claims processing center, where healthcare-related information about the patient is gathered.
The Global Claim Management System market is estimated to grow at a CAGR of 5.9% from 2014 to 2019.
The Global claim management system market is segmented by components, deployments, end users, applications, types, products and geographies. On the basis of components the market is further segmented into Hardware (Healthcare IT), Software (Healthcare IT), and Services (Healthcare IT). On the basis of deployments the market is further segmented into On-premise, Web-based and Cloud-based deployments. The end users segment is further segmented into Office based Physicians, Hospitals, Emergency Healthcare Service providers, Nurses and Other End-users. On the basis of types the claim management system market is further divided into integrated and standalone solutions. On the basis of major geographies the market is segmented into region such as North America, Europe, Asia and Rest of the World (RoW).
The report presents In-depth study of Market shares, of the top companies of the market. The numbers are arrived through extensive secondary research validated by focused primary research by interviewing industry experts, key opinion leaders such as MDs, CEOs, directors, and marketing executives.
1 INTRODUCTION
1.1 Objective of the Study
1.2 Market Definition and Scope of the Study
1.3 Markets Covered
1.4 Stakeholders
2 RESEARCH METHODOLOGY
2.1 Integrated Ecosystem of Claim Management System
2.2 Arriving at Claim Management System Market Size
2.2.1 Top-Down Approach
2.2.2 Bottom-Up Approach
2.2.3 Demand (Consumption) Side Analysis
2.2.4 Macro Indicators
2.3 Assumptions
3 EXECUTIVE SUMMARY
4 MARKET OVERVIEW
4.1 Introduction
4.2 Comparison with Healthcare Workflow Systems(parent) market
4.3 Market Drivers and Inhibitors
4.4 Demand Side Analysis
4.5 Vendor Side Analysis
5 CLAIM MANAGEMENT SYSTEM, BY PRODUCT
5.1 Research Methodology
5.2 Introduction
5.3 Comparison with Healthcare Workflow Systems (Parent) Market
5.4 Vendor Side Analysis
5.5 Standalone Claim Management System
5.6 Integrated Claim Management System
5.7 Sneak View: Healthcare Workflow Systems (Parent) Market, By Product
6 CLAIM MANAGEMENT SYSTEM, BY DEPLOYMENT
6.1 Research Methodology
6.2 Introduction
6.3 Comparison with Healthcare Workflow Systems (Parent) Market
6.4 Vendor Side Analysis
6.5 Cloud-based Market, By Geography
6.6 On-premise Market, By Geography
6.7 Web-based Market, By Geography
6.8 Sneak View: Healthcare Workflow Systems (Parent) Market, By Deployment
7 CLAIM MANAGEMENT SYSTEM, BY COMPONENT
7.1 Research Methodology
7.2 Introduction
7.3 Comparison with Claim Management System (Parent) Market
7.4 Vendor Side Analysis
7.4 Services (Healthcare IT) Market, By Geography7.5 Software (Healthcare IT) Market, By Geography
7.6 Hardware (Healthcare IT) Market, By Geography
7.8 Sneak View: Healthcare Workflow Systems (Parent) Market, By Component
8 CLAIM MANAGEMENT SYSTEM, BY END-USER
8.1 Research Methodology
8.2 Introduction
8.3 Demand Side Analysis
8.4 Vendor Side Analysis
8.5 Hospitals
8.6 Office based Physicians
8.7 Nurses
8.8 Emergency Healthcare Service providers
8.9 Other Healthcare Providers
8.10 Sneak View: Healthcare Workflow Systems (Parent) Market, By End-user
9 CLAIM MANAGEMENT SYSTEM, BY GEOGRAPHY
9.1 Research Methodology
9.2 Introduction
9.3 Vendor Side Analysis
9.4 North America Claim Management System Market
9.4.1 North America Claim Management System Market, By Application
9.4.2 North America Claim Management System Market, By Type
9.4.3 U.S. Claim Management System Market
9.4.3.1 U.S. Claim Management System Market, By Application
9.4.3.2 U.S. Claim Management System Market, By Type
9.4.4 Canada Claim Management System Market
9.4.4.1 Canada Claim Management System Market, By Application
9.4.4.2 Canada Claim Management System Market, By Type
9.4.5 Mexico Claim Management System Market
9.4.5.1 Mexico Claim Management System Market, By Application
9.4.5.2 Mexico Claim Management System Market, By Type
9.5 Europe Claim Management System Market
9.5.1 Europe Claim Management System Market, By Application
9.5.2 Europe Claim Management System Market, By Type
9.5.3 Europe - Other Geographies Claim Management System Market
9.5.3.1 Europe - Other Geographies Claim Management System Market, By Application
9.5.3.2 Europe - Other Geographies Claim Management System Market, By Type
9.5.4 United Kingdom Claim Management System Market
9.5.4.1 United Kingdom Claim Management System Market, By Application
9.5.4.2 United Kingdom Claim Management System Market, By Type
9.5.5 France Claim Management System Market
9.5.5.1 France Claim Management System Market, By Application
9.5.5.2 France Claim Management System Market, By Type
9.5.6 Germany Claim Management System Market
9.5.6.1 Germany Claim Management System Market, By Application
9.5.6.2 Germany Claim Management System Market, By Type
9.5.7 Spain Claim Management System Market
9.5.7.1 Spain Claim Management System Market, By Application
9.5.7.2 Spain Claim Management System Market, By Type
9.5.8 Italy Claim Management System Market
9.5.8.1 Italy Claim Management System Market, By Application
9.5.8.2 Italy Claim Management System Market, By Type
9.6 Asia Claim Management System Market
9.6.1 Asia Claim Management System Market, By Application
9.6.2 Asia Claim Management System Market, By Type
9.6.3 Asia - Japan Claim Management System Market
9.6.3.1 Asia - Japan Claim Management System Market, By Application
9.6.3.2 Asia - Japan Claim Management System Market, By Type
9.6.4 India Claim Management System Market
9.6.4.1 India Claim Management System Market, By Application
9.6.4.2 India Claim Management System Market, By Type
9.6.5 China Claim Management System Market
9.6.5.1 China Claim Management System Market, By Application
9.6.5.2 China Claim Management System Market, By Type
9.6.6 Asia - Other Geographies Claim Management System Market
9.6.6.1 Asia - Other Geographies Claim Management System Market, By Application
9.6.6.2 Asia - Other Geographies Claim Management System Market, By Type
9.7 Rest of World Claim Management System Market
9.7.1 Rest of World Claim Management System Market, By Application
9.7.2 Rest of World Claim Management System Market, By Type
9.8 Sneak View: Healthcare Payer IT Market, By Geography
9.4 SNEAK VIEW: Healthcare Workflow Systems (Parent) Market, By Geography
10 COMPETITIVE LANDSCAPE
10.1 Mergers & Acquisitions
10.2 Other Expansions
10.3 New Synergies
11 CLAIM MANAGEMENT SYSTEM, BY COMPANY
11.1 Aspect Software
11.1.1 Overview
11.1.2 Key Financials
11.1.3 Product and Service Offerings
11.1.4 Related Developments
11.1.5 MMM Analysis
11.2 Cerner Corporation
11.2.1 Overview
11.2.2 Key Financials
11.2.3 Product and Service Offerings
11.2.4 Related Developments
11.2.5 MMM Analysis
11.3 Avaya Inc.
11.3.1 Overview
11.3.2 Key Financials
11.3.3 Product and Service Offerings
11.3.4 Related Developments
11.3.5 MMM Analysis
11.4 Oracle Corporation
11.4.1 Overview
11.4.2 Key Financials
11.4.3 Product and Service Offerings
11.4.4 Related Developments
11.4.5 MMM Analysis
11.5 Infor
11.5.1 Overview
11.5.2 Key Financials
11.5.3 Product and Service Offerings
11.5.4 Related Developments
11.5.5 MMM Analysis
12. APPENDIX
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PRODUCT TITLE | PUBLISHED | |
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North American Claim Management System The North American payer claim management market has gained a significant share in the total payer claim management market. The market was pegged at $1811 million in 2012 and is estimated to achieve $2576 million by 2018, with a growing CAGR of 6.2%. The market can be segmented on the basis of types and various types of deployments and componenets, the report further segments the market into major geographies, end users, companies, and macro indicators. Deep-dive analysis of the top players of this market have been considered in this report |
Upcoming | |
European Claim Management System The European payer claim management market has gained a significant share in the total payer claim management market. The market was pegged at $753 million in 2013 and is estimated to grow at a CAGR of 5.3% in the forecasted years. The market can be segmented on the basis of types and various types of deployments and componenets, the report further segments the market into major geographies, end users, companies, and macro indicators. Deep-dive analysis of the top players of this market have been considered in this report |
Upcoming | |
Asian Claim Management System The Asian claim management market has gained a significant share in the total payer claim management market. The market was pegged at $386 million in 2012 and is estimated to achieve $547 million by 2018, with a growing CAGR of 6.2%. The market can be segmented on the basis of types and various types of deployments and componenets, the report further segments the market into major geographies, end users, companies, and macro indicators. Deep-dive analysis of the top players of this market have been considered in this report |
Upcoming |