Full Stack API integrations for Claim Processing

The Problem: Claims Processing is Complicated

Insurance claims involve multiple steps and stakeholders, making the process slow and difficult to track. HR teams spend hours handling claims, employees face uncertainty, and insurers deal with redundant queries.

Broker and insurer systems often operate independently, leading to inconsistent data formats, processing delays, and misaligned claim records. This results in errors, additional back-and-forth communication, and discrepancies in claim statuses. Employees and HR teams often see conflicting information depending on which system they check, causing frustration and confusion in an already stressful process.

Nova Benefits provides API integrations with TPAs like MediAssist to reduce manual work, improve tracking, and ensure smooth claim settlements. Insurance claims involve multiple steps and stakeholders, making the process slow and difficult to track. HR teams spend hours handling claims, employees face uncertainty, and insurers deal with redundant queries. A simple, structured approach is needed to make claims processing more efficient.

Nova Benefits provides API integrations with TPAs like MediAssist to reduce manual work, improve tracking, and ensure smooth claim settlements.

How Claims API Helps

1. Claim Intimation: Quick and Simple Filing

This API helps Nova's Ops team submits claim details directly to the TPA/Insurer, ensuring all required information is sent in a structured format. This eliminates errors and reduces manual effort for HR teams and employees - and also magically reduces 30 mins of manual labour!

2. Claims Sync: Real-Time Status Updates

The API fetches the latest claim status from MediAssist, so HR teams and employees always have up-to-date information. No need for follow-ups or checking portals manually.

3. Claims Query: Faster Resolutions

If additional information is needed for a claim, this API retrieves pending queries and allows responses to be sent directly through Nova. This minimizes delays and ensures claims are processed faster.

4. Claims Letters: Easy Access to Documents

When a claim is approved, partially settled, or rejected, the official settlement letters are automatically fetched and stored. Employees and HR teams can access them without searching through emails or portals.

Why This Matters

Inefficiencies in claims handling lead to wasted time and frustration. APIs help by:

• Reducing the manual workload for HR teams

• Keeping employees informed at every step

• Ensuring insurers receive accurate and structured information

• Avoiding delays caused by missing or incorrect data

Stronger Partnerships with TPAs and Insurers

Nova Benefits' deep integrations with TPAs and insurers ensure smoother communication and faster claim resolutions. These partnerships improve service levels, reduce turnaround times, and make claims processing predictable and reliable.

Keeping Everyone Informed

Automated notifications ensure employees and HR teams receive real-time updates about their claims. From the initial submission to final settlement, all stakeholders stay informed without needing to chase updates.

### The Future of Claims Processing

Traditional claims processes rely heavily on manual work, making them slow and inefficient. AI agents can take claims handling to the next level by automating complex workflows, predicting potential issues, and proactively resolving claim-related queries. With AI-driven claims management, employees get instant support, HR teams experience reduced workload, and insurers can process claims with higher accuracy and speed. Nova’s AI-first approach ensures that claims are handled with minimal friction, providing a smarter, more seamless experience for everyone involved.