The Importance of Premium Billing and Payment Reconciliations for Health Insurance Carriers Within a Consumer-Oriented Marketplace
In this challenging healthcare market, with changing regulations, outdated and disparate systems and processes, limited resources, as well as the growing consumer expectations of their healthcare relationships, complete and accurate information is a necessity to ensure both excellent member experiences and plan viability for healthcare carriers. Within the administrative processes, ensuring that individual member billings produced and payments received are properly reconciled, and actual and potential discrepancies are captured, categorized and reported, with leakage kept to a minimum, is significantly important.
Having a proper tool for billing and payments reconciliation processes in place is critical in order to ensure that the services provided and billed for are quickly and appropriately collected, and any discrepancies determined, reported and analyzed. In order to keep individual related premiums low, and operational efficiencies high, data integrity and reconcilement processes, which are automated around discrepancy determination, analysis, resolution and correction, will create the most value.