Health Insurance Articles
Two Ways To Help Streamline A Health Insurance Claim
2010-07-24
Health insurance coverage is essential today to offset the cost of increasing medical care prices. Experts have determined processing a paper health insurance claim form is expensive, inefficient, and a very complex process that requires streamlining to manage and minimize these costs. The physician loses significant time and staff in processing claims which overall cost billions each year. One consequential reason is that providers who charge a fee for services involve several different claims being billed to different insurers. This results in both labor and revenue costs and is an administrative burden to the provider's staff. These costs totaled over 45 million dollars and equaled 12% of patient revenue. The claims process could be streamlined with standardized and electronic claims processing.
This system would affect saving billions of dollars from third party processing. It would include a single regulation claim form for all providers. Today, different forms require a time investment during processing; each form is processed with different information and a separate format with different data entry criteria for each health insurance claim form. On the standardized form, the categories and information would be identical for each provider. It would save both the provider and the third party processing staff valuable time and thereby minimize costs. Additionally, the use of standardized claim form submission rules and a standardized payment schedule would simplify health insurance claim processing and would result in efficacy. Furthermore, it would benefit the physicians and health care providers by reducing the time required for payment from 15-20 days or more to 3-5 days.
Health insurance coverage reimbursement procedures usually involve the completion and submission of a health insurance claim form to the health insurance coverage provider and a consequential delay before payment. Another way to streamline this health insurance claim processing is through electronic submission and by utilizing an automatic debit card. For example, if a patient with a FSA (flexible spending account) purchased prescriptions totaling $200, the patient would simply pay with an automatic debit card. The funds would instantly be drawn from the FSA. Additionally, electronic claims submission operates in the same manner, the provider is paid immediately without claims preparation or submission that will simplify workflow for the provider and accelerate the provider payment process and reduce paper claims expenses significantly.
Finally, streamlining health insurance coverage claim form processing will help to lower the medical care costs; the investment of time and staff would be minimized. These steps are consistent with the inherent cost conservation principles and intent of the Health Reform Act.
