Claims Adjudication Checklist: How Efficient Is Your Operation?

Use this quick, 5-part self-assessment to benchmark your claims operations and uncover hidden gaps in throughput, accuracy, audit readiness, and more.

Takeaways:

  • Evaluate key metrics in less than 10 minutes

  • Identify your biggest operational risks

  • Pinpoint gaps in surge capacity, compliance, and technology

  • Get a performance tier score to guide next steps

Rework, Delays, and Compliance Risk—Sound Familiar?

Even high-performing payers struggle with claims inefficiencies. From missed prompt-pay windows to mounting backlogs and audit exposure, the warning signs are often there—but difficult to quantify.

This checklist helps you uncover:

  • Where manual processes are slowing your teams down

  • How confident you are in audit readiness and accuracy

  • Whether you're truly scaling to meet volume spikes

  • If operational misalignment is impacting provider or member satisfaction

See What Our Clients Are Saying

  • "Our relationship with Imagenet has proven to be both operationally effective and economically beneficial. Their responsiveness, structured reporting, and quality oversight make them a true operational partner — not just a vendor."

    — Carrie Kraner, Vice President, Client Experience, DentalXChange

  • "I can’t say enough positive things about how engaged Imagenet was, how clear they were about what could be done and when it could be done, and most importantly, about how they delivered."

    — Wayne Troutman, Chief Operations Officer, RAM Technologies, Inc.

  • "With Collateral Management Module® (CM) and Benefit Package Module® (PBP), our team was able to develop and fulfill over 46,000 plan documents for more than 480 unique plans—Individual & Family (on & off-exchange), Small & Large Group plans. Imagenet’s support made the entire process smoother, faster, and fully compliant."

    — Leading Southwest MA & Commercial Group Plan

  • "Imagenet scaled quickly, integrated seamlessly, and delivered exactly what we needed to stay compliant."

    — Director of Claims Operations, Large Public Health Plan

  • "Our partnership with Imagenet has been a significant step up in both quality and responsiveness. The accuracy and consistency of their digital mailroom solution has driven stronger data and reporting, faster turnaround times, and more streamlined operations in our bill review process."

    —  SVP, Corporate Strategy, National Healthcare Financial Services Company

Get the Checklist. Know Where You Stand.

Download your free claims operations checklist today to benchmark performance, flag risks, and drive smarter internal discussions.

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