Both Large and Small Companies Rely on Medical Claims Software to Manage Benefits Programs

Both Large and Small Companies Rely on Medical Claims Software to Manage Benefits Programs

Healthcare claims and processing software

As more and more Americans have gained access to health insurance through the Affordable Care Act, it should come as no surprise that a growing number of companies are implementing medical claims software. And in a time when the politicians in Washington continue to battle over whether or not the Affordable Care Act will remain sustainable, it seems likely that even more companies will need to rely on medical claims software to adjust to upcoming changes. Health benefits are a major part of most people’s compensation plans, so it is essential that these benefits are accurately tracked and distributed. When companies continue to offer not just one, but a choice between two or three, health plans the task of monitoring these plans is monumental.
Monumental clerical tasks are often easier to manage when a company employs healthcare claims and processing software. This healthcare claims processing software must, however, be supported with frequent updates and immediate help staff. Because no one knows when a health care question will arise, it is often necessary that any medical claims management software is backed by a 24/7 help team.
Revenue cycle management (RCM) is a financial process that utilizies medical billing software from registration and appointment scheduling to the final payment of a bill or balance. Medical RCM packages are the processes that healthcare facilities use to track patient care events, an extra check to make sure that all paperwork and follow up appointments are scheduled.
As both employers and health care facilities continue to deal with the changes in health care coverage, many factors create a need for medical claims software to track those changes and the implementation of a variety of plans:

  • 60% of the amount owed by patients is never collected, according to Medical Group Management Association data.
  • 50% of Americans in 1962 over 65 had no health insurance. The latest data, however, indicates that only 2% of Americans over 65 lack coverage today.
  • 60% of Baby Boomers will be managing a chronic condition by the year 2030.
  • 40% of Americans under 65 have employer-based healthcare coverage.
  • Most hospitals and health systems need to cut costs by up to 30% over the next five years to be competitive, according to Kaufman Hall.

Accuracy and follow up are important when companies and providers deal with the expense of today’s health care needs. Medical claims software can assist with both of these functions.


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