a closer look at payer benefits
Connection is key. HI Card can connect to any insurance provider, third-party administrator, pharmacy benefits manager or claims payer through API integration. Submissions must match the eligibility within HI Card to be accepted— greatly reducing identifier-related errors and potential medical fraud.
In turn, HI Card requires that all participating payers meet specific claim payment turnaround times. Average claim payments will be days, not weeks or months. Auto-adjudication and pre-authorization of claims will be emphasized and utilized within all plan design options.
- Immediate and positive patient ID
- Standardization of claims submissions
- Fewer claims and patient data errors
- Reduced medical fraud
- Auto-adjudication due to bundled bill/fee schedule
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Disturbing industry trends...
Incorrect patient identifier information is the most common issue that leads to claims errors, claims reprocessing and delayed payments. In addition to sifting thru patient identifier errors, claims payers must also sift through claims packed full of complex medical coding that is often riddled with charges that are in excess or irrelevant to the services rendered.
Private health insurance spending increased 4.2 percent to $1.2 trillion in 2017. Private health insurance coverage continues to be more prevalent than government coverage, at 67.2% of the covered population.
Given the continuous increases to health expenditures as described above, insurers can only pass along the increases through their premiums or shift cost through higher deductible and higher out of pocket health plan designs.
accurate. anytime. anywhere.
HI Card utilizes technology from Blockchain, partnered with Smart Cards/EMV Chip cards to access employee health data, such as health insurance plan details, historical medical records and personal identification. This information can be accessed by approved healthcare providers to improve the quality of care given to an individual by making the entire healthcare delivery process more transparent, efficient and cost effective to the primary parties of a healthcare transaction; the employee, provider and the payer.