The Increasing Risk of Operating on an Outdated or Under-Supported Claims Administration System

Technology is evolving faster than ever before with the explosion of generative AI and large language models, as well as serverless computing and APIs. Meanwhile, the health insurance industry is becoming increasingly competitive with innovative startup companies entering the market and transforming the typical insurance business model by focusing on process optimization through automation and expedited claims handling.

In this rapidly evolving market, healthcare payers need to consider these questions:

  1. Where will your claims administration technology vendor be in five years?
  2. And what does that mean for your business?

Transitioning to a next-generation administration system can help you automate business processes, reduce administrative costs, respond to changing regulations and grow your business.


Are You Operating on an Outdated or Under-Supported Platform?

Outdated administrative processing systems lack the capabilities of modern platforms, and the gap is only getting wider. Under-supported systems may provide essential functionality, but they are quickly falling behind in terms of compliance with government regulations and benefit shifts. Sticking with an outdated or under-supported system places your organization at a severe disadvantage and puts you in danger of getting left behind on the technological curve.

Older claims processing systems are difficult to support due to their old code, outdated architecture, underlying technology and sub-optimal design. It takes a significant resource investment to support new lines of business, respond to changing regulations and enable interoperability and in some cases, your outdated or under-supported system simply cannot accomplish what your business needs.

The bottom line is that systems that don’t seamlessly work together introduce problems. And those problems will only get worse with time.


Where is Your Technology Vendor Going to be in Five Years?

Vendors providing outdated or under-supported claims administration systems make a lot of promises for future improvements, but they rarely deliver. The truth is that there are insurmountable limitations on what their systems can provide, and they simply can’t keep up.

If you’ve been in a long-term relationship with your claims administration system vendor, you may have become complacent and stopped evaluating their capabilities. Or perhaps you have considered switching vendors, but you haven’t been able to get traction on the project or it gets deferred due to competing priorities. As you think about your business, the most important question to ask is:

If you were starting from scratch and building your business from the ground up, would you still choose your current claims administration system?

If the answer is no, then consider what might be holding you back from making a change.


Download the Whitepaper

Download the full white paper to continue reading and learn about:

    • The four questions you should ask to quickly assess your current technology platform
    • The five most common fears expressed by healthcare payers when it comes to replacing their outdated claims administration system and how VBA can help to alleviate those concerns
    • How to get unstuck and start moving forward with your technology modernization efforts




Let’s Continue the Conversation

At VBA, we are proud to provide our clients with the technology they need to succeed. Contact us today to learn more about how our solutions can help your business run more efficiently.