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The “Enhancing Efficiency in Claims Processing with Orion New UI Updates” webinar, presented by Sean Garrett (COO) and Sarah Lesowski (Product Solution Manager), focused on recent enhancements in the Orion interface. These updates aim to streamline the claims processing workflow, improve task management, and increase the overall efficiency of claims examiners and customer service representatives working within the Quantum Choice™ system. Here are the main points covered:

1. Improved Claims Queue Management: Orion’s user interface now features advanced claims queue capabilities, allowing administrators to create and assign claims queues based on specific criteria. Each queue can be tailored and assigned to individuals or groups, making it easier for claims examiners to focus on their designated tasks. The system now serves claims in a prioritized order, preventing examiners from “cherry-picking” easier cases unless specified by role-based permissions. This prevents unnecessary toggling back and forth with the Quantum Choice (QC) interface, enhancing efficiency by keeping examiners within Orion.
2. New Work Claim Form: A significant UI update includes the “Work Claim Form,” which offers claims examiners an expanded, intuitive view of each claim, focusing specifically on pended claims and the issues needing resolution. The Work Claim Form allows users to drill down into claim details such as service lines, adjudication, and payment details. The system is optimized for large monitors, enabling claims examiners to work on a claim in one view, rather than jumping between screens.
3. Claim Overrides and Task Assignment: Orion 24.1 introduces expanded support for performing claim overrides directly within the Orion interface. Claims examiners can now adjust a claim’s adjudication details, payment amounts, fee schedules, and more without switching back to the Quantum Choice UI. Task management is also improved, allowing tasks to be assigned to different departments or individuals. Users can set task reminders and due dates, and the system notifies both the task assigner and assignee, ensuring all steps are tracked and completed in a timely manner.
4. Enhanced Support for Pended Claims: Orion’s interface now supports a wider variety of pended claim scenarios, reducing the need for examiners to revert to Quantum Choice. Analysts can view claims missing information, such as provider or member details, and access the electronic data interchange (EDI) details associated with the claim. Orion now provides visual cues to highlight claims with missing information, allowing examiners to quickly identify and resolve issues. With this release, claims can be fully processed, adjusted, and approved all within the Orion system.
5. Additional Functionalities for Complex Claims: Orion’s updated interface includes features like cascading claim actions for multi-line institutional claims, enabling batch processing actions, which is especially useful for large claims. Claims examiners can now perform overrides on multiple lines or even entire claims where the same adjustment is needed, reducing the time spent on repetitive line-by-line updates.
6. Role-Based Permissions and Security Controls: Orion respects Quantum Choice’s existing role-based permissions, which restricts access to sensitive claim actions based on user roles. This feature enables managers to define which users can perform specific overrides, providing additional security and control.

The webinar concluded with a Q&A session, where participants raised requests for further customizations, such as adding more granular control over override permissions and options to display or hide claims details based on specific adjudication actions. Attendees were encouraged to submit additional feedback, which the team plans to assess for future Orion updates.