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Insurance providers, health insurance providers, healthcare providers, nursing homes, care services, and assisted living centers offer a coordinated services between different specialist groups round the clock. Professionals working for these specialist groups operate in shifts, requiring a definite handover of duties at a pre-defined time, quite similar to a relay race 24 x 7 x 365. They have to simultaneously deal with a number of active cases on a day-to-day basis as well as stay responsible and accountable for the queries and regulatory compliances of their universal caseload, including active and inactive ones. Manual record keeping breeds latency in the system and inhibits seamless operations. A digital platform, on the other hand, allows to adopt a dynamic approach in case management, at scale, and creates a seamless expressway for delivering new products and expanding operations in new geographies. It enables the providers to maintain a minute-by-minute detailed record of the services delivered and the resulting outcomes for each and every case, which is serviced and executed. It allows the primary owner and the other authorized users to access the information at the finger tips during servicing and care providing.
Case Management is an aggregation of duties comprising planning, processing, coordinating, implementing, and monitoring the services delivered for each case, such as an insured, a patient, or a care home inhabitant, in the Insurance and Healthcare domains. In most cases, a dedicated case manager is the primary owner. It is a relationship manager in the insurance domain and a doctor in case of healthcare provider setups. The primary owners are responsible for a number of concurrent cases on a day-to-day basis. They are responsible for delivering benefits to their customers at the same time ensuring that there are no revenue leakages for their institution. In addition, they are accountable for any regulatory compliance query that may arise in the future.
A digital platform enables seamless Case Management of current as well as historical cases. It records all the demographic details, case details, events and the services delivered on a daily basis and during the lifetime of the case. It allows to generate a detailed snapshot or a dashboard of the real-time status of the insured or the patient, which assists in proactively managing the case on a day-to-day basis.
Following are the best practices for maintaining up-to-date case information in real-time –
A digitally enabled case management platform offers immense benefits of scale to the institutional providers –
Servicing and care providing are full time jobs in the Insurance and Healthcare Provider domains, respectively. Harnessing technology best practices over a digitally enabled platform not only allows the primary owners / case managers and the care providers to proactively service their customers and patients but also frees their time from manual administrative processes to focus on their core competence of customer relationship building and care giving.