for Claim Management

Hello everyone,

I’m Pedro, I am a referral partner and project manager who supports companies implementing and providing consultation and training.

I am working with one company implementing a medical claim management process in Claim management in US is a lengthy and complex process with many different steps, stakeholders and paths. There are even dedicated tools to manage this kind of process but it can also be implemented with with some initial planning.

The whole process contains 11 boards connected between each other’s, with 8 dashboards to monitor all the projects and provide meaningful data.

The initial stage of the project was dedicated to capture the process in order to understand the different casuistries. I created a flowchart incorporating in it the most relevant actions.

Once the process was captured, interviewing the owner of the process, I implemented it in
Each board contains 80 columns, some of them dedicated to incorporate formulas to summarize the data and provide the meaningful information about the status of the claims and the payment.

To manage the workflow, within each board, and between each of them, there are 60 automations that simply the process and reduce errors.

Finally, to display the most relevant information, the project contains 8 dashboards that gather information from several boards at a time. (The data displayed here is dummy information).

I hope it may serve as inspiration for managing claims with


Thank you so much! I am in the process of creating Dispute Management process (instead of medical claims- it is financial claims) So your message has a perfect timing for me! :heart: