Accurate Capture of Health Insurance Benefit Verification

Capturing a patient’s insurance information correctly is a crucial aspect of the healthcare process. Otherwise, any sort of miscollection of information can contribute to the $262 billion worth of healthcare claims that are rejected every year. The margin of error is partially due to archaic collection methods, such as pen and paper, digital intake, and OCR intake methods. The options aren’t able to accurately identify payers and plans from images, which can lead to a future claims denial. 

Therefore it is recommended that an AI enabled insurance benefit  verification system is built to minimize these errors. The question for most companies is whether to build or buy their own system. The cost and technical skill to build a system in house is very high. In fact,  the initial investment can cost as much as $1 million to $5 million, and recurring costs can triple that amount. There is also the risk that if there is any sort of breach of cyber security, customers will no longer be willing to use the system. 

As an alternative, buying solutions from outside providers, mostly through API subscriptions, allows for quicker deployment and less expensive upfront costs. All of the building expertise is outsourced to a third party vendor as well, so the training and upskilling costs can be avoided as well.