The Struggle is Real - Controlling Administrative Costs
The Struggle is Real
Today, both administrators and human resource
professionals continue to struggle with the ongoing challenges within group
health plans. Employers are seeing rising costs and administrators are
dedicating more resources to maintain expectations.
Technological advancement within healthcare has been slow at best, as
increasing costs, both external and internal, have limited funding and are being
delayed. This is forcing employers to downgrade to less comprehensive plans
to maintain budgets, adding additional constraints for administrative support.
These circular patterns are taking a toll in today’s workforce leaving
management to wonder what the next step is (see illustration on page 2).
There are viable solutions to controlling internal costs. Many employers
are turning to administrative tools to consolidate employee tasks as they come
up. Providing the proper structure is the first step to controlling excessive
internal costs.
1) Implement a company-wide portal dedicated to key tasks in the group health
administrative role. Provide resources within this portal to offset the constraints
that human resource personnel is taking on day today.
2) Assigning the appropriate personnel to the proper task. The #1
concern for HR is the lack of support for both acute and nonacute billing
issues. Due to increasing costs and lower revenues, many insurers fail to
provide billing support, passing the buck on to administrative and HR personnel.
Without the guidance of a medical professional proficient in medical coding and
balanced billing, many claims often go unaddressed after several attempts to
resolve the issue.
3) Immediate and instantaneous support for all employee-related issues.
Implementing efficient technologies where billing services, employee
educational materials and virtual physicians can all be accessed off of the
employee’s smartphone and all monitored by administrative support.
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