Quick digital transaction tools, such as virtual cards, can play a significant role in assisting claims processors in responding quickly and issuing funds that are simple for physicians to accept and processors to deliver.
Fremont, CA: In the United States, the health insurance industry is a major industry, with most employers mandated to provide coverage to full-time employees. Businesses may meet this obligation by paying monthly premiums to insurance carriers in exchange for employee coverage. Still, some argue that this approach may result in employers spending more on coverage than their employees actually use.
Thus, an increasing number of businesses are opting out of so-called "fully insured" plans in favor of self-funded health plans to save money. Businesses use their own budgets to pay out employees' healthcare claims hoping that the costs will be less than the premium expenses they would otherwise pay to insurance companies.
Healthcare claims processors must deal with a diverse and frequently changing set of physicians. Most businesses in other industries have simpler accounts payable (AP) responsibilities because they only have to make B2B payments to a few dozen regular vendors, but claims processors do not have the same degree of reliability and consistency.
The transition toward self-funded insurance alters the payment flows as well. Traditional insurance plans require businesses to make recurring, fixed payments to insurance providers, whereas self-funded options require businesses to make claims payouts quickly in amounts that vary depending on the specific needs covered.
