Prashant Jhaveri, Head, Products and Strategy, Medi Assist Healthcare Services, was recently featured in an article on Healthcare Executive. He discussed how eCashless makes it possible to plan a cashless hospitalization from the comfort of your home. Here is what Prashant had to say:
Healthcare, Insurance and Technology
“Medical inflation in India stands at 12-15 percent as against a global average of 6-7 percent. With the cost of medical care constantly increasing, there is little doubt that more and more people will opt for health insurance policies to hedge themselves against the risk of high out-of-pocket expenses.
Cashless hospitalisation is one of the primary benefits availed by insured members. But, for a person who is already in the throes of a potential hospitalisation, the prospect of paperwork to obtain pre-authorisation for cashless hospitalisation can often seem to be a daunting task. In the case of an emergency hospitalisation, customers often seek instant guidance on choice of network hospital, cost of treatment, expected out-of-pocket expenses, necessary paperwork, etc.
Third party administrators (TPAs), as the conduits between the insurer and the insured, attempt to make these crucial touch-points as customer-friendly as possible; and technology plays a significant role in realising this goal. In fact, health benefits administrators cannot reach their true potential by merely processing claims. They must morph into technology and implementation partners and transform patient experience before, during and after hospitalisation.
Consumer Happiness during Planned Hospitalisation
Technology has significantly redefined consumer experience, wherein anything from a train ticket, to groceries or a family vacation can be accessed with the flick of a button on your smartphone. The time is ripe to leverage technology to enable the same experience within the healthcare industry, and certainly within the health benefits industry.
Pre-authorisation at the time of hospitalisation always leads to some tense moments. Predominantly a manual process, until the recent advent of online cashless claims managements systems, cashless hospitalisation requires members to obtain a pre-authorisation form at the insurance desk at the hospital, fill up the form in conjunction with the treating doctor, send it to the TPA via fax or email, await the approval from the TPA and then be ushered in for a cashless admission. Family members would often have to leave their unwell relatives unattended and wait at the insurance desk to know the status of their pre-authorisation request. This often leads to an agonising wait and loss of precious time for the insured as well as the hospital. This apart, there is also a lot of anxiety about the estimated cost of treatment, availability of a preferred room type and the out-of-pocket expenses that the family would have to incur.
The key to consumer satisfaction during hospitalisation lies in encouraging members to plan their hospitalisation with as much care, and importantly as much ease, as possible with the help of technology. Features such as eCashlessTM today make it possible to plan a cashless hospitalisation from the comfort of your home, with a smartphone, even before the expected date of hospitalisation.”
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