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Private Health Insurance What Is The Cost For Your Clinic?

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Denpa News In Spain, although we have extensive healthcare coverage, waiting times are increasing, which means that one of the reasons driving the growth in demand for private healthcare is the need for patients to have care quality medical without waiting, or at least in a reasonable time.

But this does not only translate into increased demand. The number of private insurers has also grown offering health services, which makes them a very important factor to take into account when working on the business model of a health center.

The role of private insurers in the health center’s business model

Every year the number of patients who are cared for in private medical centers with health insurance increases.

This situation has made insurers an intermediary to consider. Their broad portfolio of clients continues to grow every year, and working with them has become a necessity in order to maintain the flow of patients necessary for the financial survival of the business.

As a consequence of this, the health center loses control over the prices that they can charge patients per consultation performed. Likewise, the health center will be obliged to negotiate the payment received for each medical act performed.

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Negotiation of rates: One of the keys in the financial management of the health center

Insurers do not work with fixed payments, but they negotiate with each medical center the cost of each service provider.

Thus, one of the first problems to solve when you decide to work with private insurers is to get a payment rate that allows you to continue offering quality medical service to your patients while taking care of the financial health of your business.

For this, it is essential that private medical centers know the costs of each medical act. Being clear about the average cost of the service is of great help in a successful price negotiation.

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Management of the relationship with insurers

Although it is not a direct economic cost, in private medical centers there is an increased cost associated with the time spent managing business relationships with insurers.

Each insurer has its own processing portal that must be used both in receiving patients and in billing them once the consultation is completed. And in addition to this, every month it is necessary to reconcile payments with the different insurers, which leads us to a scenario like this:

  • Each company works with its own processing portal
  • The admission staff uses different access codes for each portal for the processing of medical acts.
  • Each insurance company has its own rating system
  • Your clinic or medical center has different business rules: One for each insurance company it works with.

How to reduce management costs with private insurers

Given the aforementioned complexity, it is to be expected that there will be solutions that help reduce costs derived from:

  • Managing patients with private health insurance
  • The commercial relationship with insurers
  • Those derived from management errors in the commercial relationship with insurers

To simplify all this management work, it is advisable to use a solution such as SEOGA, which is integrated into the HIS (Hospital Information System) of any type of clinic or private hospital and allows that, from this same software, all procedures can be carried out with private insurers, as well as the subsequent exploitation of the information.

Additionally, it is important to have an Information System such as DenpaNews , a medical management software that allows integrating all clinical management in a single solution.

 

 

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