The health insurance sector continues to develop rapidly through the emergence of new technologies. With quality integration of specialized digital solutions, insurance companies together with healthcare institutions and IT teams are creating a new healthcare environment.
Insurance companies are expected to lead towards more flexible management of health insurance products and better patient treatment outcomes while facilitating the process for all involved stakeholders. In the first 11 months of 2023, an astounding 5,671,590 health insurance claims were settled in Croatia, which is 472,556 more than in the same period last year. This is a clear sign that digital transformation, especially in the domain of claims processing, is a safe and reliable way to achieve those goals and to keep up with the trends and growing demands of the insurance market.
1. Independent definition of products
The dynamics of today’s insurance market require every company to quickly adapt to new trends and insurance products, as well as inevitable changes in existing ones. The process of product definition/change is traditionally time-consuming, both due to internal processes and due to communication and coordination between the company and the IT team in charge of the IT system. As a solution in this situation, the possibility of independently defining one’s own products is imposed. Complete control and personalization of products, significantly reduced time-to-market, and saving of human and financial resources are just some of the benefits that this type of solution brings.
2. Digital collaboration
The power of integration and the company’s connection with external partners, institutions, and its users has never been more valuable, and this trend hasn’t skipped the health insurance sector either. For health insurance services to be provided smoothly from the provider to the end user, it is desirable to enable the company’s API connectivity with all involved partners, especially healthcare institutions. The biggest advantage of this type of connectivity is the complete automation of health insurance claims processing. The real-time exchange of data on valid policies and coverages, as well as the automatic authorization and reporting of claims when using medical services must be reliable, integrated, and instant.
3. Medical Help Desk
In the saturated world of unreliable and sometimes contradictory information, correct and timely information is worth its weight in gold, especially in the context of health. The Medical Help Desk module enables efficient management of prescriptions and telephone or written correspondence with users of additional health insurance and health institutions. The implementation of the module mentioned represents added value for your users, and in the long term, can strengthen their trust in your services.
Of course, the successful use of such digital solutions rests on the premise that the insurance company has already actively included modules such as: automatic underwriting, repricing, management of health cards (digital and physical), and management of contracts with health care institutions. Efficiency will also improve with unified claims and authorization management, a Document Management System, and an efficient reporting system.
Example of successful implementation
In the already mature health insurance market in Croatia, the implementation of the CUBIS solution in the insurance company Triglav represents an example of successful implementation and long-term good cooperation.
In the record time of only 2 months, their IT system procedurally covered the entire spectrum of insurance business domains – from product definition, sales, underwriting, commissioning, premium bookkeeping, reporting, claims, and numerous other processes. At the same time, vital connections were established with numerous health institutions and partners via API. In addition to efficient claims processing, this also improved the overall experience of the insured clients.
If we look at the success of Croatian companies that use the CUBIS solution for health insurance, it is evident that technological innovation is not only a means of monitoring trends but a key strategy for achieving high efficiency, quick adaptation, and creating a connected and personalized health service.
