Data Sheet: Point-of-Service Payment System Success - Integrated Ecosystems (PDF)
Traditional claims systems are often fragmented and inefficient, leading to significant errors and unnecessary operational costs.
Fragmented and Inefficient Claims Systems
Traditional claims systems are often fragmented and inefficient, leading to significant errors and unnecessary operational costs. Gartner's findings underscore the severity of this issue, noting that between 3% and 7% of all healthcare claims are paid inaccurately. In worst-case scenarios, inaccuracies can soar as high as 50% for specific services. The root of these discrepancies lies in the reliance on multiple, disjointed systems that require manual intervention and frequent data updates.
Benefits of Integrating a Cohesive Ecosystem
Integrating a cohesive ecosystem could addIress these inefficiencies, ensuring prepayment accuracy, reducing human error, and streamlining communication. This approach parallels the seamless connectivity found in modern smartphone ecosystems, where various applications and services work harmoniously. By adopting single-instance solutions, healthcare payers can achieve consistent, accurate results, improve data accessibility, and enhance decision-making capabilities.
HealthEdge’s Advocacy for Integrated Ecosystems
HealthEdge advocates for a shift towards integrated ecosystems that support point-of-service payments, promising not only operational efficiency but also improved relationships with providers and members. This transformation requires enterprise-wide support and commitment to modernizing legacy systems to foster openness and integration.
Empowering Healthcare Organizations
Ultimately, the adoption of integrated ecosystems can empower healthcare organizations to deliver better care and make data-driven decisions, setting the stage for a more efficient and transparent future in healthcare.
