Does your plan suffer from high costs due to workflow inefficiencies? Does your staff struggle with providing quality services and care to patients?

This may be due to outdated workflow management processes.

While the world continues to advance, discovering new technologies to better day-to-day life, many health plans and payers still remain in the past with respect to healthcare administration.

In this article, we will explain

• The importance of healthcare workflow management
• How you can use technology to optimize workflows for healthcare payers and plans
• Examples of developing healthcare workflows with technology

Let’s dive in.

The Importance of Health Plan Workflow Management

Optimizing workflows is all about identifying inefficiencies and fixing them. By correcting these procedures, healthcare professionals can spend less time on tedious tasks and more time delivering quality services and care to patients.

Streamlining workflows helps your organization reduce errors, ensure compliance with regulations, and improve your quality of care. From there you are able to produce successful value-based outcomes and refine member services.

If you are a business owner or manager you need to make sure you are providing your staff with the resources required to optimize workflow processes. This means keeping your organization up to date with the latest technology available.

Medicare Advantage (MA) Plans Need Streamlined Workflows

If you are a Medicare Advantage Health Insurance Plan you know how important it is to have a high star rating. It can be what sets you apart from other plans and ensures potential enrolees that you deliver quality plans.

The Centers for Medicare and Medicaid Services (CMS) is a trusted source so getting a high star rating from them can highly influence enrollees. To ensure you get your desired scores your organization needs a medical and benefits management technology.

How Technology Can Optimize Workflow Processes for Healthcare Payers and Plans

Technology investment can optimize workflow processes by:

• Progressing patient care
• Enhancing coordination
• Streamlining documentation procedures
• Boosting communications
• Reducing tedious and redundant tasks

Now, let’s detail the different steps you can take when using new technology to optimize your workflows.

Update Communication Throughout Your Organization

Outdated communication operations like following up on unanswered calls or playing phone tag with providers wastes a lot of personnel time.

Modernizing to hi-tech, automated communications can alleviate inaccurate information and increase timely member outreach. If your team improperly handles calls or doesn’t reply promptly to a member, it can adversely affect patient engagement rates and star ratings.

By automating the repetitive tasks, the team is free to handle the more pressing matters at hand. Using technology can result in quicker response times, higher member satisfaction, error elimination, boosted staff morale, and overall cost savings.

Remove Wasteful Paper Processes

Practices that involve paper such as patient files are another drain on resources where technology can assist. Staff can spend countless hours chasing down paperwork and files.

By replacing as many paper operations as possible with new tech, you can save time and money, and reduce manual errors.

Crucial information can be lost or misfiled with paper documentation, causing payments, patient claims, and eligibility information to fall through the cracks. Cloud-based portals, member platforms, and computerized documentation systems all advance workflows. Allowing staff to work securely throughout all departments with all types of devices, wherever they are.

Utilize Automation to Save Time

Automation allows for the elimination of some tedious manual tasks saving time for performing quality care. One-third to one-half of administration costs are from billing and payment transactions between providers and payers.

By automating, mundane and repetitive tasks, your staff is able to dedicate their time and energy toward more crucial functions. A payer claims process is the perfect operation where automation can play an important role and make a sizable impact on staff and capital.

Dealing with third-party payers can consume an enormous amount of your staff’s time. There are many repetitive tasks and every payer has their own set of requirements. A healthcare platform can help automate many mundane steps and ensure more efficient and accurate billing.

Adopt A.I. to Strengthen Operations

As A.I.’s capabilities and benefits become more recognized, more industries have adopted it in their daily operations. The American Medical Association (AMA) shared ways that they believe A.I. can improve workflows.

For example, payers can use A.I. for automating and collecting data to streamline workflows in eligibility and benefit verification.

It can advance:

• Point-of-care learning – reduces wasted time looking for research
• Reporting – removes manual data-collection
• Documentation – creates efficient patient documentation

Health care professionals are adopting A.I., and it is becoming imperative for your business to keep up.

Enhance Analytics to Uncover Inefficiencies

Technology allows you to consolidate and analyze data to pinpoint areas for improvement or needed action.

With a tech-forward healthcare system, you can obtain dynamic metrics, alerts, and reports. Your team can monitor performance, analyze key performance indicators, and compare them to performance benchmarks. Then, you can turn this data into integrated and actionable insights in record time.

The use of technology for analytics can help lower costs, become more compliant with regulations, detect fraud, enhance quality of care, and streamline your operations.

Revamp Your Operations with HealthAxis Solutions

By adopting cloud-based technology into your day-to-day practices, you can refine your workflow processes. From the first point of contact with your patient to sending them the final bill, every aspect can run smoothly with healthcare tech.

Seeking to advance your healthcare business? HxOne allows you to manage your analytics, technology, and day-to-day operations in order to provide quality care to your members and reduce your costs.

Through our tech-enabled services, you can provide enhanced customer service, adapt quickly, and offer new products to members, all while reducing your overall risk.

Request a demo today to learn how HealthAxis can develop your workflow and streamline your operations.