Why managing your claims can be very complex?

Companies usually require a large group of resources to process their claims. The complexity of claim processing can vary from the receiving point and claim validations to the final payouts generation.

Common claim processing complexities:

• Handling different types of claim templates

• Time-consuming on manual reconciliation

• High risk of erroneous payouts

• No approval workflow process

• Missing integration with accounting (accrual/credit/debit) systems

How can Pricefx helps you to manage your claims?

Pricefx offers a capability that helps you:

• Eliminate complex claims processes and integrate your distributor claims management into one uniform platform that manage any type of format (EDI, web-service, XLS)

• Link to Agreements & Promotions and Quoting to define special price agreements that are checked automatically

• Reduce the risk of mistakes and miscalculations often encountered during manual claims processing

• Validate any claims based on flexible and customized rules with systematic, timely, and accurate results

• Seamless visibility into program eligibility, validity, exceptions, accruals, and payout calculations

Typical Use Cases

• Inaccurate, manual, off-line claims validations performed in legacy systems (XLS)

• Prolonged unresolved claims periods

• Lack of supporting detail for disputes (proof of sales/invoices)

• Duplicate line items and overclaiming (ERP)

• Inability to forecast and evaluate the success of programs

• Unable to handle contracts with GPOs (buying groups)

• Unable to handle admin fees to brokers

• Inability to use MDF (marketing) lump-sum & event-based (no SKU)

• Inability to create payout schedules

• No scrubbing or validation of claims

Channel Management Key Functionality

The Channel Management capability offers the following functionalities:

Claim Types

Claim types address different claiming conditions with specific fields or rules. You can have as many claim types as your business requires and each claim type has associated a claim validation logic or formula.

Claims

The Claims functionality allows you to create, manage, track and display all your claim validations. It offers a view of the claim status, progress, and approval results. You can export/share your claim results with customers, distributors, and business partners.

Claim Records

Claim records are created for each validated claim upon its approval. This list will represent the approved and validated claim records ready for the accounting process in your ERP system.

Where to start with Claims Management?

Pricefx offers predefined algorithm logic to perform the claim validations. You need to have in place the following requirements:

• Historical data for the effectiveness of previous contracts/customers/products

• Claim templates (file/format)

• Claim logic - customized validations (if required)

• Contract setup

• Sales orders/invoice information to forecast accrual/expected payouts

• Approval workflows for validation notifications/resubmissions

• Payout scheduling