Health insurance payors play an important role by serving as active intermediaries between the patient, the hospital, and the health insurance company. They integrate clinical, claims, operational and financial data from multiple sources, negotiate discounts with hospitals, and settle the medical bills on behalf of the patients they represent.
It is the goal and a key comparative advantage for any health insurance payor to be able to create value for patients by facilitating the best possible healthcare within budget.
Finding the best health insurance payor
Hospital Management has listed some of the leading medical insurance payors based on its intel, insights and decades-long experience in the sector.
The list includes health insurance payors that are specialised in processing and settling general medical, dental, long-term care and employee healthcare insurance claims.
The information contained within the download document is useful for hospital administrators, billing executives, healthcare insurance planners and managers, medical insurers and any other individual associated with health insurance product development, marketing and claim processing.
The download contains detailed information on healthcare payors and their product and service lines, alongside contact details to aid your purchasing or hiring decision.
Role and functions of medical insurance payors
While health insurance companies pay the cost of medical care, it is the insurance payors that are responsible for processing patient eligibility, enrolment, healthcare services and insurance claims.
The functions of a medical insurance payor include, but are not limited to:
· Negotiating or setting rates for medical services
· Collecting revenue through premium payments
· Processing hospital’s claim for inpatient medical care services
· Collecting payments from the insurance companies, and
· Settling medical bills with care providers on behalf of the patients
Technology opportunities for health insurance payors
The future medical insurance payors could leverage artificial intelligence (AI) and advanced analytics to enable the delivery of targeted and predictive healthcare services based on the available physical, clinical and biological data.
Healthcare payors can also strengthen care coordination and improve patient safety by adopting advanced digital technologies. They can streamline collaboration and communication among multiple stakeholders in a single hub while keeping sensitive health information private and secure and making the claim process even simpler and stress-free.
Download our list here.