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Why Outsourcing Claims Management is Crucial for Business Growth

Last Updated on 24 Jun, 2025
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Why Outsourcing Claims Management is Important for Business Growth

Rising administrative costs, ever-evolving regulations, and tight cash flow are the roadblocks standing in the way of healthcare organizations striving for greater efficiency and profitability. But what if there was a solution that alleviates these burdens and helps organizations flourish in a complex and competitive landscape?  

Outsourcing healthcare claims management is a proven strategy to reduce costs, enhance compliance, and drive scalability in an increasingly complex healthcare environment. 

 Mirra offers healthcare organizations a streamlined, automated solution to manage the entire claims lifecycle. Key benefits include cost reduction, faster processing, error reduction, improved cash flow, compliance with regulatory bodies, and operational efficiency. By adopting Mirra’s claims adjudication software, healthcare organizations can not only reduce costs and increase efficiency but also stay ahead of industry changes, driving long-term growth and profitability. 

Ways to Achieve Measurable Results with Outsourced Claims Management 

 Achieve Business Results with Outsourced Claims Management

In today’s competitive healthcare landscape, businesses need to make decisions that reduce operational inefficiencies and directly impact their bottom line. Outsourcing healthcare claims management to a trusted partner like Mirra can deliver significant cost savings, faster processing times, and increased profitability. Here are a few key statistics that demonstrate the tangible benefits of outsourcing:  

  • Reduced Administrative Costs: Studies have shown that outsourcing medical claims management can reduce administrative costs by up to 30%1. Organizations can eliminate inefficiencies and significantly reduce overhead by automating manual tasks and streamlining claims processes.  

  • Improved Claims Processing Time: Organizations that outsource claims management typically experience a 40% reduction in claims processing time2. With Mirra’s claims adjudication software, healthcare organizations can expect faster claim turnaround, accelerating reimbursements and improving cash flow.  

  • Cost Reduction per Claim: On average, the cost to process a medical claim in-house is $5.60 per claim. Outsourcing to Mirra can reduce this cost to $3.00 per claim, freeing up resources that can be reinvested into higher-value areas of your business.  

  • Error Reduction and Fewer Denials: Mirra’s claims adjudication solution helps reduce error rates from the industry average of 30% to less than 0.1%. This results in fewer claim denials and rework, which leads to fewer claims pending additional information and reduced administrative burden.  

  • Enhanced Cash Flow: By automating claims processing and ensuring faster reimbursements, healthcare organizations can expect an improvement in cash flow as claims are adjudicated more quickly and accurately. For example, some of Mirra's clients have experienced a 25% improvement in cash flow within the first six months of implementation.  

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Outsourcing healthcare claims management is not just a tactical move to reduce operational costs—it’s a strategic decision that can drive long-term growth and profitability. Organizations can unlock multiple ROI opportunities by partnering with a trusted claims management provider. 

Key Benefits of Mirra’s Claims Adjudication Software

Benefit Impact
Cost Reduction Saves 25–30% on operational costs
Faster Claims Processing Reduces claims processing time by 40%
Error Minimization Reduces error rate from 30% to <0.1%
Enhanced Cash Flow Speeds up reimbursements, improving cash flow by 25%
Regulatory Compliance Ensures automatic compliance with regulations
Scalability Adapts to growing operational needs without added costs

Increase Cash Flow and Reduce Costs

One of the most immediate financial benefits of outsourcing medical claims management is the potential for significant cost reduction. Healthcare organizations can save 25-30% on operational costs by outsourcing claims management. This cost reduction stems from the automation of manual processes, reduced error rates, and the need for fewer internal resources dedicated to managing claims.  

By freeing up these resources, your organization can reallocate funds and personnel to more value-added activities—such as improving patient care, expanding services, or investing in new revenue-generating opportunities.    

Improve Patient Satisfaction

The speed and accuracy of claims processing benefits your organization’s bottom line and improves patient satisfaction. Faster claims processing also means fewer billing errors, which leads to a better experience for patients who won’t have to deal with delays, confusion, or frustration of incorrect billing.  

This enhanced patient experience can foster better relationships, improve patient retention rates, and create opportunities for positive word-of-mouth referrals—all contributing to sustained growth.  

Enhance Operational Efficiencies

With a solution like Mirra’s claims adjudication software, your organization benefits from a fully automated system that improves operational efficiency. Automating claims processing reduces the burden on internal staff, allowing them to focus on more strategic activities rather than getting bogged down by administrative tasks.  

Mitigate Compliance Risks

Staying compliant is costly and time-consuming in an industry where regulations constantly change. Outsourcing claims management allows your organization to leverage an automated solution that aligns with the latest healthcare regulations, including CMS guidelines and data privacy laws.  

This level of compliance reduces the risk of costly penalties and legal issues, safeguarding your organization’s reputation and ensuring you operate within legal boundaries.   

Drive Long-Term Business Growth

The cumulative effect of reduced operational costs, improved cash flow, better patient satisfaction, and regulatory compliance is enhanced business sustainability and growth. Healthcare organizations can focus on strategic growth initiatives. Whether that means expanding your services, entering new markets, or investing in cutting-edge healthcare technologies, outsourcing provides the financial flexibility and operational efficiency required for scaling your business in a competitive healthcare environment.  

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Stay Ahead of Healthcare Trends with Mirra's Solutions

Advance Healthcare Trends

The healthcare industry is undergoing rapid transformation. Healthcare organizations that leverage contemporary advancements will be better positioned to meet the demands of an increasingly complex and competitive healthcare landscape.  

AI and Automation 

AI and automation are revolutionizing medical claims management. AI-driven solutions reduce error rates, speed up claims processing, and proactively identify discrepancies, minimizing costly errors.   

Mirra’s claims adjudication software, featuring ClaimsLite for paper claim entry and ClaiMaster for adjudication, automates the process, improving accuracy and efficiency. This automation allows your organization to handle more claims without extra costs, leading to faster reimbursements and significant savings.  

Interoperability and Data Integration 

Interoperability—the ability for different systems and platforms to seamlessly share and exchange data. As healthcare providers, payers, and patients demand more integrated care experiences, the need for systems that can communicate with one another is becoming paramount.  

Mirra Healthcare offers seamless integration with third-party systems, ensuring that claims data can be easily shared across different platforms without the risk of data silos. This enhances provider, payer, and patient collaboration, leading to more informed decision-making and faster claims processing.  

Evolving Regulations and Compliance

It is of utmost importance to stay compliant with the latest healthcare regulations. HIPAA updates and CMS regulations are continually evolving, and organizations must ensure that their claims processing systems are always up-to-date.  

Mirra’s claims adjudication software is built with compliance in mind, ensuring that your organization stays aligned with the latest regulations from CMS, HIPAA, and other governing bodies. By outsourcing your claims management to Mirra, you can ensure that your organization remains compliant with regulatory changes without needing constant manual updates or additional administrative oversight.  

The Shift Toward Value-Based Care

As healthcare moves toward value-based care models, organizations must find ways to improve patient outcomes while managing costs. Outsourcing claims management can contribute to this shift by improving operational efficiencies, reducing unnecessary administrative overhead, and reallocating resources to patient care and value-driven services. Mirra’s solutions help healthcare providers maintain a focus on quality care, as claims processing and reimbursements are managed efficiently in the background.  

Conclusion

By outsourcing your healthcare claims management to Mirra, you're not simply reducing operational costs but creating a scalable, high-efficiency solution that drives business growth.  

Make the strategic decision to enhance your operational efficiencies, maximize revenue, and reduce overhead costs with Mirra’s advanced claims adjudication software. Get a no-obligation demo today to learn how Mirra can help your organization achieve its business objectives. You can also look at our Medicare Advantage in a Box to learn about the latest products and services our domain experts offer.  

References: 
1.https://cpamedicalbilling.com/the-growing-importance-of-outsourced-medical-billing-services-key-trends-and-statistics-for-2024/  

2.https://www.decerto.com/post/efficient-claims-management-systems-key-features-and-benefits#:~:text=Efficient%20claims%20processing%20is%20the,higher%20customer%20retention%20and%20loyalty 

 

Tags
healthcare claims management
claims adjudication software
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Reviews & Testimonials

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NANCY GAREAUCEO of Ultimate Health Plans (Retired)

"In 2021, Ultimate Health Plans (UHP) partnered with Mirra Health Care (Mirra) to develop a software platform to support processing Claims, Customer Service, Eligibility, Enrollment, Premium Billing, Encounter Processing and a Provider Portal for our Medicare Advantage Plans. Mirra collaborated well with our operations and compliance teams to successfully design and implement a system that was innovative, efficient, and compliant with all Medicare and Florida Medicaid guidelines and requirements all within the scope of our required timeline. We greatly benefitted from the Mirra Project Management Team’s regular communication with Stakeholders through monthly meetings and recurring weekly breakout-focused calls, which were geared towards troubleshooting and goal alignment. Mirra was able to quickly maneuver and adapt their systems to our needs, resulting in successful implementation and go-live. Mirra continues to support our compliant operation and growth in the ever-changing healthcare industry rapidly and effectively updating their systems with new Medicare and Florida Medicaid rates and guidelines to ensure seamless compliance and efficiency. I have absolutely no reservation in recommending their systems to any Payer searching for improvement in their operational efficiency."

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