3 Reasons to Invest in Apps as a Health Insurance Payer

By Randy Tomlin, CEO & Chairman of the Board, MobileSmith Health
Twitter: @TheMobileSmith

The lack of clarity into a patient’s current healthcare benefits like deductibles, services used, and out-of-pocket maximums can be confusing to say the least. Speaking from experience, receiving up-to-date information on where I currently stand is many times not an easy process to say the least.

It usually consists of weeding through paper statements sent to me in the mail, struggling to log into a mobile app that’s not great, and is double checking my insurance card to view coverages at the doctor’s office.

As an insurance payer, allowing patients to easily access arguably the most important information related to their overall health can have huge cost-saving impacts for both payers and patients. Here are three main benefits that mobile apps offer for health insurance providers:

Access to in-network care options
According to a Peterson Kaiser Tracker, about twenty percent of employees file out-of-network claims for services. This can be a problem because many times patients have no idea if specialists they are seeing (from referrals or otherwise) to are covered under their current plan.

One use case that could be a huge cost saver is the ability to locate in-network Urgent Care centers or other facilities in a time of need. Some, like Sallyanne Johnson have dealt with the financial burden of receiving an unexpected doctor’s bill of $356 as a result of selecting an out-of-network urgent care center.

Urgent care centers continue to be a huge benefit not only for patients – but their insurance providers due to the costs of receiving care at emergency rooms. Giving patients a clear picture of what facilities accept their insurance is a key piece of the decision making process, whether it be finding an urgent care center or a specialty clinic in a time of need.

The urgent care example is one use case that we are seeing in healthcare apps more and more, and is the kind of functionality that can be applied in the payer context. Allowing access to wait times at various in-network facilities is another added benefit, in addition to driving directions, hours of operation, and more.

Visibility into benefits used, deductibles, and more
As one of the most useful and practical use cases, providing a mobile app that provides digital insurance cards is key in a paperless age. However, one of the primary benefits of having an app is the ability for patients to view this information on a dashboard.

Easily viewing and accessing information on benefits can obviously be a challenge if a patient’s provider does not provide the technology to make this a convenience experience. Most major players in the auto industry (for example), already offer this type of experience.

Take Geico, for example. You can easily view digital ID cards, your current claims, bills, deductibles, and even chat with a virtual assistant.

Providing peace of mind with this type of technology is key for health insurance companies, whose primary policy holders are becoming more and more mobile first (and mobile only). Offering this type of visibility goes a long way in boosting patient satisfaction and can be a key differentiator for insurers with really good app experiences.

Reducing costs by helping patients reach health goals
Providing instant access to policy-related information is obviously one of the most important functions to include, but another incentive for insurance companies (that also benefits policy holders) is the ability to promote healthy living.

Helping patients reach milestones and accomplish health goals has tremendous cost-saving benefits for payers, as they continue to find ways to help reduce costs in any possible way. As an example, insurers like Anthem and United Health have already provided over 350 million dollars in free housing, food, and medicine to help reduce costs according to a recent Forbes article.

Providing these additional services may seem costly, but still makes financial sense due to the overwhelming cost burden of insuring patients who frequent the emergency room.

Providing personalized recommendations within healthcare insurance apps is something that has tremendous potential, especially in the context of lowering premiums for insurers. It really seems like a no-brainer considering the amount of money spent elsewhere.

Here are a few concepts to consider:

  • Information about local community events
  • Personal development opportunities based on interest
  • Workout guides
  • Information on nearby fitness centers
  • Daily health tips

Keeping patients truly engaged to what matters most to them – their health, is one area to focus on as a health insurance provider in the coming years. While there are a handful of apps out there, many simple do not offer the type of seamless experience to make them really worth using. With healthcare spending at an all time high, giving patients a better control panel for managing their health will be a huge piece of the equation.

This article was originally published on MobileSmith Health and is republished here with permission.