Effective management of medical claims is an extremely complex task. What make it difficult for insurers to improve the claims operations are the numerous steps and variations involved in each process. As insurance payouts also form a significant part of an insurer’s costs, medical insurers need to discover a better way to reduce claims processing expenses.
However, it’s essential to note that the insurance policy holders’ right to receive fair and equitable settlement and their service needs must never be compromised just for cost-efficiency measures. Medical insurance companies should give more importance to high-quality experience since the satisfaction and loyalty of policy holders is largely dependent on their experience when processing their claims.
Below are best practices for improving efficiency of medical claims processing:
Use Automation Tools
The key to improving accuracy and efficiency of healthcare claims processing is automation. Insurance companies must take advantage of advancements in optical character recognition and other technologies that may alleviate the struggle that their staff had to endure in the past because of having to utilize different templates for different forms.
Using the right tools, insurers can be confident that no data is missed. That’s because machine learning and artificial intelligence ensure that errors are caught in the early stages of the process. Essentially, the use of automation tools takes accuracy to the highest level to improve the overall efficiency of healthcare claims processing.
Outsource Medical Claims Processing
When it comes to healthcare claims processing, one beneficial step that insurance companies can opt to take is outsourcing the majority of the process to a BPO agency like Smart Data Solutions. When choosing a service provider to outsource your healthcare claims management, look for one with the right tools and experience required to streamline workflows, both on paper and electronically.
For years leading up to the COVID-19 pandemic, laboratories all around the world had been dealing with severe staffing shortages and major budgetary constraints. Those factors combined to push many facilities to the brink of closure and kept the rest from operating at full capacity for long stretches of time. Then, when the pandemic struck, those issues exploded into a full-blown crisis.
But it wasn’t all bad news. That’s because the sudden flood of work coupled with the need to reduce person-to-person transmission of the virus has prompted many facilities to speed up their plans to adopt additional automation solutions into their workflows. And it’s also giving researchers a reason to push the boundaries of current laboratory automation technologies to see what’s possible.
Here’s an overview of the forces behind automation’s growth in laboratories, as well as how the available technology is coming together to create the laboratory facilities of the future.
Automation Adoption Rising
Even as the pandemic continues to rage, there’s growing evidence that automation is going to emerge as the cornerstone of the post-COVID-19 laboratory. Already, industry analysts are beginning to include the pandemic’s effects on the market. One such analysis predicts that the pandemic is behind an accelerating growth rate expected to top a 6% CAGR between now and 2024. That outlook points to a huge uptick in both interest and investment in automation technologies, at a pace that far outstrips pre-pandemic levels.
Outside Investment Increasing, Boosting Upgrades
It’s also important to note that the surge in interest (and need) for laboratory automation isn’t happening in a vacuum. It’s happening at a time when laboratories are receiving a burst of both public and private funding streams intended to help them scale up to meet current and future challenges. In the US, the Department of Health and Human Services recently announced over $6.4 million of additional funding going to two major US labs to help them purchase new equipment to increase their capacity in the near term.
Stress and anxiety are a big part of everyone’s lives these days. The uncertainty that has taken over the world, since the start of the coronavirus crisis at the beginning of the year, has yet lo leave. People are looking for ways to manage their stress and anxiety, so that they can cope better with the new realities. Today, they can turn to a connected object called Spire to do so.
A Start-Up to Answer Every Need
It would seem like there are new start-ups popping-up everyday, ready to tackle on a need still unsolved by another corporation. That is the case with Spire who saw a niche and decided to launch itself into the void that existed. But before connected objects came on the market, there was already online help to relieve stress and anxiety. It is the case with Intermittent Breathing, where professionals are teaching breathing techniques for anxiety, which can help people going through this difficult time in history.
Nothing is more important than recovering normal breathing, when suffering through stress and anxiety. Otherwise, more ailments will come such as headaches, digestive problems and cardiovascular troubles. It is the one solution studies recommend, when going through rough patches, as it was proven to work best against other strategies in various research.
Many people who suffer from depression rely on medication to help relieve their mental health disorder symptoms. However, antidepressants and similar drugs are not the only options to help you cope with your symptoms.
Many methods can help you counter the symptoms of major depressive disorder that do not require the use of prescribed medicines and can help avoid the associated side effects and costs of some of the medicines currently prescribed for depression. Read on to find out which natural methods can help tackle the symptoms of depression.
Improve your sleep
Your emotional well-being and quality of sleep go hand in hand. Neglect your sleep and it will have a negative impact on your mood, regardless of whether you have symptoms of depression or not. Good sleep hygiene means going to bed and waking up at around the same hour consistently. Your bedroom should be ready when you go to sleep: dark, uncluttered, and quiet. Improving your sleep hygiene can have a hugely positive effect on your mood, that will impact your whole day.
Limit your caffeine intake
Soda, tea, coffee, and often chocolate will contain masses of caffeine, which is ok to have in the morning in reasonable quantities. If you have a caffeine dose in the morning, you should avoid it in the afternoon to ensure it doesn’t impact your sleep later. If this does happen, it can negatively affect your overall mood.
If you feel a reliance on caffeine, you could try gradually reducing your intake to skip the effects associated with caffeine withdrawal. Try taking a short walk when you crave caffeine, a soda or cup of tea to try and reduce your need for caffeine.
Get answers to your concerns about face masks, consisting of how to use them appropriately. Can face masks help slow the spread of the coronavirus (SARS-CoV-2) that causes COVID-19?
Yes, masks combined with other preventive measures, such as frequent hand-washing and social distancing, help slow the spread of the infection.
In fact if you’re a dentist, we recommend that you market your dental practice by highlighting how safe your practice is now.
Masks can be made from common products, such as sheets made of tightly woven cotton. Directions are easy to find online. Cloth masks should consist of numerous layers of fabric. The CDC site even consists of instructions for no-sew masks made from bandannas and T-shirts.
The CDC suggests that you wear a fabric face mask when you’re around people who don’t deal with you and in public settings when social distancing is challenging. They also suggest you wear them in health related spaces such as when you go in for your first dental visit. This also applies to kids. Which means they have to even wear them even after getting braces. It’s just the new norm.
Some suggest that certain fabric, such as dishcloth material, deal exceptional filtering of infection particles than others. DIY strategies likewise call for incorporating HEPA filter products from vacuum cleaner bags into mask styles. However, without an airtight seal, none of those products will provide considerable security against the contraction of the infection for the wearer. Convenience, not product, needs to be king when developing a mask. An uncomfortable mask that requires constant modification indicates more face touching and removal, he stated, causing more, not less, danger of contamination.
The U.S. Department of Health and Human Services (HHS) announces that five cooperative agreements to health information exchange organizations (HIEs) to help support state and local public health agencies in their efforts to respond to public health emergencies, including disasters and pandemics such as COVID-19.
The HHS Office of the National Coordinator for Health Information Technology (ONC) is administering $2.5 million in funding from the Coronavirus Aid, Relief, and Economic Security Acts (CARES Act) signed by President Trump on March 27, 2020.
The funding will support local health information exchanges (HIEs) under the Strengthening the Technical Advancement and Readiness of Public Health Agencies via Health Information Exchange (STAR HIE) Program.
Each of the five recipients will work to improve HIE services so that public health agencies can better access, share, and use health information during public health emergencies. These efforts will also support communities that are disproportionately impacted by COVID-19.
“Health information exchanges have long served important roles in their states and regions by helping health data flow to treat patients,” said Don Rucker, MD, national coordinator for health information technology. “These STAR HIEs will help public health officials make real-time decisions during emergencies like fires, floods, and now, the COVID-19 pandemic.’
The five HIEs, each awarded two-year cooperative agreements, are:
Georgia Health Information Network, Inc. (GaHIN)
Georgia Health Information Network will support the Georgia Department of Public Health and Georgia Department of Community Health to better access, share, and use electronic health information, especially data from populations underserved and/or disproportionately affected by the COVID-19 pandemic. This will include increasing the reporting to a state-wide COVID-19 registry and expanding public health reporting and data enrichment for providers not connected to GaHIN.
Health Current (Arizona)
Health Current (Arizona) will support the Arizona Department of Health Services by improving the timeliness, accuracy, and completeness of hospital reporting of key COVID-19 healthcare data, including facility hospitalization metrics, personal protective equipment (PPE) inventories, and ventilator inventory and utilization. Health Current will also seek to reduce hospitals and health system burden related to state and federal reporting requirements by using the HIE as a data intermediary.
HealthShare Exchange of Southeastern Pennsylvania (HSX)
HealthShare Exchange will modernize the region’s pandemic response with the use of automated application programming interfaces (APIs), supporting the Philadelphia Department of Public Health and the Pennsylvania Department of Health. HSX will also facilitate public health agency use of the Delaware Valley COVID-19 Registry, and create new clinical data connections based on public health agency priorities.
Kansas Health Information Network, Inc. (KHIN) d/b/a KONZA
The Kansas Health Information Network’s KONZA team will expand the number of providers participating in the HIE, enhance lab data that is already being exchanged and combining it with existing HIE data for public health reporting, and add additional information to its real-time alerting platform for the Kansas Department of Health and Environment.
Texas Health Services Authority
The Texas Health Services Authority, in partnership with Healthcare Access San Antonio (HASA, a regional HIE covering multiple regions in Texas), a local hospital partner, and Audacious Inquiry (Ai), will conduct a proof-of-concept pilot to demonstrate real-time, automated exchange of hospital capacity and other situational awareness data through APIs using HL7 Fast Healthcare Interoperability Resources (FHIR). This improved reporting will support the Texas Department of State Health Services.
These five awards represent a range of activities across different geographic regions of the country. The cooperative agreements will include cross-recipient collaboration to leverage their collective expertise and ensure the sharing of implementation experience gained from the program. This will bolster the likelihood of success and enable better replicability of the projects throughout the country.
Updox commits itself to “cultivating an environment that is diverse and inclusive—with equal opportunities for everyone.” Updox is designed to organize all patient communications, secure and SMS texts, secure email, e-faxes, referrals, reminders, and even video chat in one engagement platform and one inbox.
It’s solutions are used by more than 350,000 users and 125 million patients, and are integrated with more than 100 electronic health records, according to the company.
Updox is a cloud-based, HIPAA-compliant solution offering a broad set of capabilities that increase patient engagement, improve internal productivity and increase revenue. Updox is based in Dublin, Ohio.
What is the single-most innovative technology you are currently delivering to health systems or medical groups?
Updox Video Chat. Pre-COVID, most practices never considered telehealth, as they thought it was complex, expensive and poised no reimbursement opportunities. COVID changed that. We’ve entered a new era of virtual care where more and more services will be provided remotely, and soon, telehealth will be essential, not a “nice to have.”
Updox made telehealth implementation simple with streamlined training, unbundling the solution to adapt to individual practice needs and increased customer service offerings so providers could get started within hours. Driven by the need and desire to continue social distancing, convenience and growing adoption by physicians, telehealth is fast changing the world of healthcare.
How is your product or service innovating the work being done in these organizations to provide care or make systems run smoother?
Updox is the place for virtual care and complete healthcare communications. Committed to simplifying the business of healthcare, Updox offers a broad set of innovative capabilities for patient engagement, provider communications and internal productivity that work together in a secure, user-friendly, easy-to-use platform. This includes our Video Chat solution.
Unlike others in the market, with Updox, healthcare providers can access a full suite of applications including secure text messaging, video chat, patient portal, appointment scheduling, automated reminders, on-demand patient messaging, credit card payments, and health alerts – all in one place. This drives improved outcomes through more efficient communications and better care coordination. Additionally, with the Updox telehealth platform patients can connect with their own physicians instead of someone unfamiliar to them – without needing to download any special apps. Healthcare partners benefit through improved relationships with patients and other providers, increased revenues, reduced costs, and enhanced business efficiencies.
What is the primary need fulfilled by the product or service?
Hospitals, health systems and pharmacies across the nation are using Updox’s platform to provide comprehensive and continuity of care — during a pandemic — that is secure, safe and personalized. The main difference in Updox’s telehealth solution is that we connect patients with their own trusted doctors (vs. Teladoc and others that match you with an unfamiliar physician in the queue). Especially during times of uncertainty, we know patients prefer seeing their own doctor. In fact, a recent Updox patient telehealth survey found that 49% of patients prefer being able to see or speak with a healthcare professional of their choice.
What is the ROI of said product or service? Provide real examples of verifiable ROI of the product or service when used in or by a health system or medial group.
For patients, telehealth offers a plethora of benefits, including cost savings, convenience and safety from potential exposure to infection.
A study from The American Journal of Emergency Medicine found that the net cost savings per telemedicine visit was calculated to range from $19–$121 per each visit (vs. an in-person visit).
For health systems, telehealth implementation is proven to save practices time and money. For example, practices can save an average of $200 per patient by reducing costs associated with missed or canceled patient appointments. In addition, according to a 2017 study, missed patient appointments cost the U.S. healthcare industry $150 billion per year. With the help of telehealth solutions – like secure video chat services – practices can recoup these losses and easily facilitate follow-up appointments, consultations and ongoing chronic condition treatments.
During COVID, many practices would have gone out of business without telehealth. For example, one Updox customer stated telehealth allowed them to see 75% of their normal patient volume — despite the pandemic. And, a separate customer reported that Updox allowed him to conduct more than 600 visits via Updox telehealth in the two months, and approximately 98% of his caseload has been via telehealth.
Sometimes, big changes in how we work and live are driven by technology. Think smartphones, for example. At other times, social change and technological innovation dovetail perfectly to help us reimagine what we do.
In healthcare, over the last decade, the focus on outcomes-based care has coincided perfectly with advances in network-based communication to open a new world of patient experience solutions that produce results for hospitals and the public. And with the coronavirus pandemic upending various aspects of healthcare delivery, this new breed of solutions, built on a foundation of secure, integrated networks and smart digital devices, can help healthcare providers meet the challenge.
“This idea of better providing services to patients, helping them stay informed and engaged during the course of their stay — educated about why they’re there, how they can get services and, ultimately, empowering them to be active participants in their care — has become the foundation of our software development,” explains Robin Cavanaugh, chief technology officer at GetWellNetwork, a Bethesda, Maryland-based company that offers a family of solutions, including GetWell Inpatient, which creates personalized, digital workflows to engage patients in their care. “We’ve found innovative ways to deliver that experience on devices in the hospital environment.”
Chief among those devices is the in-room television. Along with the ubiquitous pillow speaker, the hospital TV tends to become the center of a patient’s world during a hospital stay. Until recently, the TV was a one-way entertainment medium. Today, it’s a smart, networked internet display capable of much more: entertainment, for sure, but also personalized education, information, interaction, and — increasingly — face-to-face communication.
“For so long, you’ve had this old TV mounted in the corner, offering little information and keeping patients somewhat disconnected from everything around them,” Cavanaugh says. “We’ve spent a lot of time trying to improve that experience, first by deploying capabilities in set-top boxes and now by aggressively integrating networked patient solutions into a new breed of smart TVs.”
Smart TVs Support a Variety of Healthcare Solutions
Smart TVs combine a traditional TV display with a built-in computing device and network connection. This all-in-one design makes them more reliable and manageable. “They eliminate external TV components, so they’re easy to install in rooms,” says Dennis Mathur, senior vice president of technology at Boston-based Aceso, developer of digital solutions for delivering personalized content and services to patients. “For installation, all that smart TVs need is a network connection. At the same time, they integrate with important in-room devices, such as pillow speakers.”
Companies like Aceso, GetWellNetwork, MDM Healthcare, Sonifi Health, TeleHealth Services and TVR pCare have reinvented patient experience using the tried-and-true television system as a healthcare portal. Their comprehensive offerings vary, but when a healthcare provider has the right information technology infrastructure in place and a network of smart TVs — securely integrated with electronic medical records (EMR) and other systems — each solution can deliver a variety of patient amenities in support of outcomes-based care, including:
Updox commits itself to “cultivating an environment that is diverse and inclusive—with equal opportunities for everyone.” Updox is designed to organize all patient communications, secure and SMS texts, secure email, e-faxes, referrals, reminders, and even video chat in one engagement platform and one inbox.
