Insurance Companies and TPAs
It becomes highly crucial for insurance companies to ensure customer satisfaction for building lasting relations with them. Seamless flow of operations in the claim settlement process is the key to win customer confidence. Remedinet solutions enable insurance companies and TPAs to speed up the entire process through exchange of relevant data with the hospitals at a click of few buttons.
It does away with the requirement of manually filling in the forms, so any inaccuracy on the part of data operator in keying the data is minimized. This exchange of electronically readable data is error free and curtails any back and fro involved in document transfers.
The data gathered from the patients at the time of pre authorization is directly fed on to the Remedinet platform which is accessible to TPAs and Insurance companies immediately. It also eliminates the entire process of the Insurance Company / TPA keying in data and scanning documents when they are received from the hospital.. The amount authorized for reimbursement is also fed into the system and is available for all involved in the cycle thereby ensuring utmost transparency.
Insurance companies and TPAs can also benefit from the standardization of processes made feasible by Remedinet products. As IRDA is moving towards making various processes standard across the claim settlement process, shifting the data capturing, monitoring and exchanging to Remedinet platform would make it convenient for insurance companies and TPAs to adapt to the change.
Availability of structured electronically readable data also enables automation of different aspects of the claims adjudication process. This enables far greater accuracy in the approval amounts reducing disallowances and revenue leakages. It also brings in greater transparency thus reducing the overheads of disputes and multiple to and fro between hospitals and payers.
Benefits to Hospitals
With a reduced turnaround time, hospitals can ensure that the patient is discharged as soon as the treatment and the recuperation time are over. They do not have to wait for confirmation from the insurance companies about the claim settlement which usually takes 4-5 hours. With faster discharge, there is optimum utilization of beds available at the hospitals thereby enhancing their profitability.
With Remedinet solutions the payment realization cycle from insurance companies to hospitals has been reduced by more than 50% which earlier was not defined. With all requisite information and documents readily available for reference, it becomes simpler for insurance companies to settle the reimburse hospitals with the final claim settlement.
To facilitate administrative decision making process, Remedinet solutions provide a dashboard facility which provides a summary of the claims settled along with the status of the payments due in the payment realization cycle. They can then conduct an analysis and take measures to speed up the revenue realization process.
The future of Healthcare Insurance
In India, majority of the population comprises of young adults who would enter the elder age bracket in couple of decades. The healthcare claim settlement infrastructure should be equipped to handle this requirement and Remedinet products would be of tremendous support in laying the requisite groundwork. Remedinet solutions are scalable and can be customized based on the language requirements of the payers and the payees.
To support the growth of the health insurance in India, it is imperative to embrace latest technology and Remedinet is offering the solution much needed by the industry. By adopting this channel of electronic exchange of data, health care industry in India is inching closer to the replicating the global best practices.
