Healthcare Workflow Management and Benefits

The healthcare system in the United States maybe some of the best and most advanced in the world, but it is also complicated and, at times, convoluted. Just the simple process of billing insurance can be incredibly complex.

Billing, for example, is one of the most complicated parts of managing the healthcare system. And it is here that the system can most benefit from better workflow management using software tools that help automate and/or streamline processes for increased efficiency.

Say we have a patient that has an insurance policy. They will need to use their insurance number to access their policy and use this policy with a doctor that is in the insurance network. The insurance number the patient provides is what the healthcare professional must submit to the insurance company to be paid for their services.

Once a healthcare professional requests payment from the insurer, it is now part of accounts receivable. From here, the patient’s portion of the bill is sent out after the insurance company gives the amount they approve.

It is easy to see how complicated this is and all we’ve done is make a claim to an insurance company for an individual going to an in-network doctor. So just imagine how difficult things can get if the person is uninsured, or happens to visit a doctor that is out of network.

Keeping all this straight and ensuring that medical systems receive timely payment for services rendered is a vital part of the healthcare system and bottlenecks here can dramatically impact the bottom line.

Better Managing These Workflows

Now that we have introduced this common, but complex scenario, it is a wonder that doctors get paid for their services and that the bills actually get paid. To close even a single account requires the healthcare manager or financial specialist to contact an insurance company, and from there, send the remainder of the bill to the patient. This means if all goes well, containing two different people and coordination payment.

This is where workflow management software comes in. Workflow management software such as Comindware’s Health Insurance Claims Management software makes it easy for IT professionals to create processes and workflows that lead to the more efficient resolution of patient accounts. This software can automatically send payment requests to insurance companies, bills to patients, and payment reminders as well. The ability to do this automatically reduces the amount of time actual people have to spend dealing with the basic paperwork associated with medical billing.

Benefits of Management

The benefits of having an effective healthcare workflow should be obvious. First and foremost, this will simplify the billing process for all parties involved. Automated reminders and payment requests can help ensure more timely receipt of payment from patients. The ability to immediately submit a claim to an insurance company and get their approval also speeds up the time between request and payment.

This software makes it easier to collect payment. Reducing the time an account is unresolved is so much better for the bottom line. Time, effort, and money are spent trying to collect on medical bills, and the ability to automate this part of the process can save time and labor. Detailed workflows will also help to reduce redundancy and allow you to see areas where you can approve the efficiency of your operations. This alone is invaluable information that can really help a healthcare system improve various parts of its operations.

And workflow management software is not just useful for billing. There is a wide range of applications for this software in the healthcare industry.

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