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TM Floyd & Company
Success Stories - Health Claims Processing in the US    There is no single method for processing health claims. In fact...      more...

Repatriation and Vendor Management

In addition to its extensive executive consulting experience supporting strategic planning, project management, and process improvement based on a best-practice approach, TM Floyd & Company (TMF) consultants have worked closely with payers needing to regain control of vendor-managed systems.

Strategic Decisions

A payer must have control over its data in order to make the strategic decisions necessary for its survival. Vendor managed systems can be beneficial and sometimes necessary for controlling IT costs, since IT system management is not necessarily a core competency for all carriers. Nevertheless, a payer only has three things which comprise its value: its membership, its claims processing system, and its data.

Data Control

Retention of membership depends upon the efficiency of the system and the ability of the executive management to adapt to data trends. If the vendor owns the claims processing system, then the only true control the payer has over its fate depends upon its ability to access its data.

Repatriation

In repatriating vendor-controlled systems, TMF will engage in: