When it comes to managing claims, medical providers have always worked in the dark. A fundamental lack of transparency into the claims management process has limited what providers can see into the process. It’s meant that providers haven’t been able to identify claims for payment that they should be getting paid on. However, the status quo is changing fast with the rise of insurtech. New claims management platforms are changing the future of insurance and providing providers with insights they’ve never had in the past.
Your claims processing system isn’t perfect. It might not even be good. Don’t worry though - you’re not alone. It’s rare to find a claims processing system that has no issues. From the speed of your adjusters to stakeholder communication issues, there’s always going to be a part of your system that can be improved. Continual improvement should be part of any business process. However, in working with insurance companies we’ve repeatedly seen the following five issues with existing claims processing systems.
There’s a problem in the insurance industry. Delays in communication, multiple layers of 3rd party interest groups such as attorneys and insurance representatives, and inefficient workflows have been causing long, drawn out processes, partial payments, and market inefficiencies. Communication issues have especially driven wedges in what we call “the provider-payer feedback loop”. The provider-payer feedback loop is the continuous dialogue between insurance provider and payer to ensure a mutual beneficial outcome for both parties. Leveraging innovative claims management software will help to close those gaps and push an outdated industry to begin to adapt with modern technology.
All we really want is to worry a little less about stuff. In times of crisis, like being hospitalized after an automobile accident, a little less pressure can go a long way to improving customer satisfaction. Recognizing this, insurers and healthcare providers alike have been relying on new claims resolution technology to become heroes to their claimants and patients, respectively.
Hospitals are losing their workers, and they need to start being extra careful about preserving their hiring budget.
A recent 2017 survey from Leaders For Today (LFT) examined the state of employment in the healthcare industry, and found that hospitals have one of the most aggressive turnover rates across industries. That churn isn’t limited to specific departments, either; from C-level administrative staff to front desk registrars, there’s a revolving door to be found.
The insurance industry is an archaic, multi-billion dollar industry ripe for disruption. There is practically no end to the opportunity to increase efficiency within the industry, and considering insurance is already a wildly-profitable segment of the market, any efficiency injected into the current process can do nothing but improve the customer experience and bottom line profits of the insurers. Even though some carriers are still conducting aspects of their business, like claims processing, in a traditional context, the operational and customer demand for faster cycle times, lower expenses, and an improved customer experience are driving a variety of automations within the industry as a whole.
Settling MVA claims often requires unnecessary litigation and involvement of plaintiff attorneys and revenue cycle management companies; ultimately creating a lengthy, expensive, litigious collections process. But why? With the exorbitant amount of cloud-based technology we have at our disposal, why isn’t there a platform for healthcare providers to skip the middlemen and settle claims directly with insurance carriers, saving time and money in the process? The following outlines how a revenue cycle solution can be aimed at doing just that.
When looking for fair revenue cycle solutions and dealing with complex MVA claims resolution, oftentimes the two primary questions are:
- Who deserves the money?
- Who really gets paid?
Today, we’re going to dive into these two questions and shed some light on who wins and who loses in the current MVA claims process.
Topics: Revenue Cycle Solutions
New insurance industry trends will be affecting millions of people as we move deeper into the digital era. From economic and labor tendencies to innovative technology, new insurance industry trends are something to keep an eye on. Here’s 7 trends in the insurance industry to watch for:
The current medical claims processing rate rarely allows for healthcare providers to receive 100% reimbursement for their services from the insurance carrier. That means the doctors and hospitals that provide the medical treatments to care for injured motor vehicle patients will never receive their full payment.