Healthcare organizations have two options for getting insurance card capture and insurance verification automation: either to make it themselves or partner with someone who focuses on providing insurance card capture and verification automation related solutions. It is important for healthcare organizations to implement an accurate insurance card capture system as errors can cost them significant amounts of money. In fact, there are at least $260 billion in insurance denials each year.
Existing options for insurance capture waste many hours, have a higher error rate and are associated with a lower success rate. Most systems are unable to identify COB (coordination of benefits), map the payer and plan printed on the instance card to the payer in the systems, identify the payers and plans from images, and validate the accuracy of the payer among other important functions.
Today, healthcare organizations have the option to build AI-enabled insurance capture and verification systems that retrain AI models to accommodate payer and plan changes while also having a team that continuously updates new payer plans and mappings. These insurance card capture systems are completely owned by the healthcare organization, however, there are risks involved when building these systems/ Some of these risks include the requirement of a highly skilled team to create and the high costs involved throughout the life of the system as well as the continuous need for capital outlay and refinements.
Buying insurance card capture systems is another option that can be more affordable. Healthcare organizations might struggle to find the right vendor that suits their needs but are rewarded with savings in support and employee costs, lower overall costs, almost no delays, and simplicity in use. An insurance card capture and verification automation system can be a customized or ready-made solution that can help healthcare organizations even better service to patients while saving on costs.
Source: Orbit Healthcare