The fee-for-service model of Reimbursement would invariably result in more expenses for greater amounts of services like tests, scans, therapies, and other kinds of treatment recommended by the providers. Healthcare spending in the United States has been much higher than in other countries, and it has a serious impact on the economy. Surveys and research by various organizations have concluded that the cost of hip replacement surgery in the United States is comparable to putting down a down payment on a house in many other countries! Many view this as a gross violation of basic human needs since every person is bound to be sick or injured at least once in their lifetimes.
Healthcare spending in the country has crossed $3.5 trillion, and it is more than 15% of the country’s gross domestic product. Moreover, that’s more than the entire economies of all but four countries – The United States, China, Japan, and Germany. The US has the lowest life expectancy of all the high-income countries in the OECD and twice the average rate of obesity.
These eye-popping numbers show a system that doesn’t help patients, but it also shows a wide chasm between the hard-earned money spent on medical care and the relatively poor outcomes for patients. Whether the medical paid through government initiatives, insurance coverage, or the patients’ pockets, they would end up with the providers.
Earlier, the health industry depended on paper-based and manual systems to organize, store, and analyse patient health informatics. This is where information technology comes into play by introducing a rapid advancement and invasion of the healthcare sector. Physicians and healthcare organizations can now efficiently store data on secure cloud-based systems. Health Informatics is a combination of health and information technology. Health informatics refers to a process that involves data collection, storage, retrieval, and presentation in a digital format to help...
Artificial intelligence-powered insurance claims analytics software would speed up the entire workflow with fewer errors and greater accuracy. Insurance claims processing considers the services rendered by the providers, checks the necessity or validity of those services, and cross-references them with the health plans of the patient. If everything seems to be in order, the claims are accepted and the provider reimbursed. But if there is a slight discrepancy, the claim might be denied or rejected.
Covid forced us to search for novel ways to improve healthcare services. mHealth provided a robust answer to the situation, and it helped us recover our lifestyles and opened up doors to a myriad of opportunities. The contract tracing in digital form was introduced thanks to the conjugation of healthcare into smartphones. This allowed the epidemiologists to monitor and control the diseases better.
Another new exploration was with the fitness apps, and these helped patients and common people monitor their...
Benefits of a Health App for Patients & Medical Professionals
Benefits of a Health App for Patients & Medical Professionals
Hospital apps have many advantages for patients as well as medical professionals. A digitized platform streamlines many activities in the everyday workflow, thereby reducing the burden for medical staff. Things that previously needed manual, repetitive procedures with pen and paper can be accomplished with a few clicks using a hospital app. Pulling up electronic health records, managing appointment schedules,...
How Can Big Data Be Used In Insurance Claims Analytics?
MD: Big data helps the analysis of large amounts of structured and unstructured data. Let us see how health care providers and insurers can use big data in insurance claims analytics.
Big data is the technology that facilitates the analysis of large amounts of structured and unstructured data. Healthcare providers and insurers can use big data to devise models. Machine learning algorithms can be developed to train insurance claims analytics machines to...
Provider Network Management Solutions Help Boost the Access to Care
A healthcare provider network is a list of doctors, hospitals, and other providers that an insurance coverage plan associates with to provide medical care to members. Providers who fall into a health plan’s network are called in-network providers and those that don’t are called out-of-network providers. In addition to clinical doctors, a health plan’s in-network providers could also include nurses, therapists, and also home care professionals.
