A hospital insurance manager is a vital part of the healthcare industry. Insurance managers are responsible for ensuring that hospitals collect premiums and claims from their patients. Hospital Insurance Managers are also responsible for submitting data to healthcare providers. One way you can make your job easier is by using hospital management software!
This blog post will discuss how this type of software can help you with your daily tasks and provide tips on what to look out for when choosing a system.
The importance of insurance management at healthcare facilities
Unlike other sectors, in the healthcare sector, the major portion of revenue is generated from insurance claims and reimbursements rather than directly from the patients. This makes the job of an insurance manager very important for the hospital, clinic, pharmacy, or any healthcare facility. Insurance managers are responsible for ensuring that they submit claims to the insurance company and collect reimbursements, reduce or keep the claim rejection rates at the lowest, reduce TAT for submissions and resubmissions with timely and accurate submissions.
Getting the right Patient Information:
Hospital Insurance Managers are responsible for submitting data to insurance providers. Data on patient information is necessary in order to submit the claims and get reimbursed from insurance companies, which can only be done if you know what provider your patient has enrolled with and what coverages the insurance provider offers, and other policy details like member ID, policy no, insurance company details, such as coverage and eligibility, pre-authorization, etc.
This data can be obtained by using hospital management software. Hospital management software has the ability to extract patient information from registers. At the time of appointment registration itself, the staff can collect all the required information and documents, and the insurance managers can retrieve them easily and be ensured that they are error-free.
Getting the right billing information:
Billing information is also very important in order to submit claims. Insurance companies will only reimburse you if they have the right billing codes and medical codes for prescriptions on file for your patient’s insurance plan.
Doing all of these tasks manually would require much more time and resources than using an automated solution like hospital management software. Hospital management software is an efficient tool that can help with submitting data and claims, which has a better rate of acceptance when you compare it to other methods of filing your data. HMS can also integrate with cross-coding software making the process smoother and error-free.
With the right hospital management software, the billing section can determine the right rate, insurance eligibility, coverage details, sponsor limits, exclusions, etc within a short period of time without error.
The benefits of hospital management software:
- It saves time by creating templates for various forms (claims, billing information).
- Reduces the risk of human errors by automating many of the processes.
- Increases accuracy and efficiency when gathering information for claims.
- Allows Insurance Managers to submit data electronically, reducing the time spent filing paperwork on paper.
- Hospital management software features such as Medical coder review help ensure accuracy of the sent information, reducing turnaround time to clarify issues and compress claim processing.
- Audit trails highlight warnings and errors which help to resolve them on time and ensure accurate claim submissions.
- Hospital management software offers insights into the number of claims that have been submitted, the percentage of resubmissions, and how successful they're at having their claims accepted.
Choosing the right Hospital Management Software:
Depending on your facility, there are a few things to consider before choosing a software solution. Let us discuss a few of them here to help you make a better decision:
- The number of people in the hospital that will use this software.
- What your budget is and how much you're willing to spend.
- How far the Hospital Management Software is compliant with rules and regulations.
- Hospital management software that can integrate with third-party cross coding software helps insurance managers submit data and claims with a higher rate of acceptance.
- Features for claim history tracking which helps to see premiums, reimbursements, and other claim-related information.
- A system supporting Cloud-based hosting would be more efficient as it can store limitless amounts of data and also ease integration with third-party insurance aggregators such as eClaim Link in Dubai, Shafafiya in Abu Dhabi, and Waseel/DHS in Saudi Arabia.
Hospitals are seeing a rise in the number of patients seeking treatment for complex medical conditions, as well as an increase in overall patient volume. This is resulting in a higher demand for hospital insurance managers to be able to handle these changes and provide quality care. With hospital management software at your disposal, you can more efficiently manage claims from all angles including pre-authorization requests and denials which will allow you to focus on providing better customer service that meets their needs.
We hope this blog has given you some insight into how hospital insurance managers can save time, energy, and resources with the help of hospital management software.
As a hospital insurance manager, it can be difficult to manage all of the different aspects that come with your job. What do you need? A tool that will help you keep up with everything from claims management and billing to patient information. Insta by Practo is the right solution for you!
Book now for a free demo!
