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Healthcare Payer Automation: Definitive Playbook for 2022



Challenges in Implementing Healthcare Payer Automation Solutions     

1. Extensive Technical Research  

When it comes to IT and digitization, there is no one-size-fits-all. The insurance payer must decide which processes will be automated. Such healthcare payer solutions cannot be the sole responsibility of an in-house IT team. There are bound to be changed in the organizational workflows.   

Not every step of healthcare payer processes’ administrative and functional aspects can be automated. Deciding on these may not be within the purview of insurance companies, and it requires experts in healthcare automation who can assess an organization and make appropriate recommendations. Furthermore, it also depends upon factors like cost and company size.   

Parameters like the features of the payer software, potential for return on investment, time for staff to get acquainted, changes to working styles are of the essence when considering a move to automation.  

2. Knowing Which Workflows to Automate  

Payers often have an elaborate, highly bureaucratic procedure to adhere to. They need to collaborate with providers for verifying patients’ health plans, analyze the coding, process the bills, check to see if treatments are covered, and then reimburse the providers. This workflow is prone to errors, which cost all the stakeholders. That’s because existing regulation stipulates that any process or technology that handles patient electronic health records must feature a certain level of data security measures.      

Only repetitive procedures that don’t require a skilled human professional can be turned over to automation. Things like verification, claims assessment, etc., have a few more or less manual aspects. Activities like these can be comfortably handed over to healthcare payer software.  

3. Employee Fear of Layoffs  

This is perhaps the most intensely contested topic of conservation when it comes to automation. Automation has already cost employees their jobs at factories, and it threatens the jobs of millions of drivers across the globe. The same holds for people in the insurance industry.  

It takes several employees to carry out routine tasks at an insurance company. But after automation for healthcare payers sweeps the industry, most of the employees in those roles are bound to be laid off. This fear is not unfounded, and top-tier management must tread a fine line when taking this step. But on the upside, automation will boost the productivity and efficiency of payers, and it can eliminate the human element and render manual, recurring activities error-free.  

4. Prioritizing Initial Investment Vs. Long-Term Gains  

As with every new investment, businesses worry about the value that the money spent can add to their organization. But automation benefits healthcare payers and providers in terms of efficiency and productivity.   

Software for healthcare payer automation that reduces staffing requirements alone would save insurers a significant amount of money. Moreover, payer solutions minimize errors in medical credentialing, claims processing, health plan verification, and the overall reimbursement procedure, in addition to speeding them up.  

As workflows grow faster and more efficient, it’s sure to reflect in the insurers’ image. Consequently, more providers and customers would want to associate with a reliable payer. As expected, this pays off in the long run. To sum it up, automated healthcare payer solutions do require a significant investment, but they’re worth every cent as they’d improve the bottom line as the years pass.  

How Does A Platform For Healthcare Payer Automation Help The Payers?      

1. Improved Health Data Management  

Manual activities invariably involve the human element and so are prone to mistakes. When it comes to healthcare, regulations ensure that errors related to medical records management incur hefty fines. Several steps in the reimbursement procedure would include access to patient records. But since healthcare payer automation can minimize human intervention, it naturally results in fewer mistakes and greater efficiency.   

2. Reduced Overhead  

As mentioned earlier, an immediate by-product of automated health systems is reducing staffing. Fewer employees mean lesser people to pay, which drives up revenues. Even better is that a payer can enjoy higher productivity with few people. The benefits of lower overhead are clear for everyone to see.  

Automation within practice management platforms has helped single physician practices to handle multiple aspects of office administration and reimbursement procedures with little to no extra help. The result is lasting satisfaction for the doctors, patients, and payers.  

3. Better Compliance   

It has integrated healthcare solutions  that feature automation to help in streamlining many aspects of care delivery. That includes the entire workflow of claims submission at the providers’ end, coupled with verification and reimbursement at the payers’ end.   

Seamless and secure electronic data exchange among different stakeholders eventually leads to better care. Automated payer management software can ensure a higher degree of compliance within medical workflows by optimizing operations.  

4. Flexibility and Scalability  

Technology for healthcare payer automation can evolve to meet changing requirements, and it can be scaled up or down depending upon the need. This gives payer organizations enormous flexibility without worrying about an increase or decrease in their efficiency.  

5. Improved Productivity  

Automated payer management software is like an employee that can work around the clock, never take a day off, and not make any mistakes. Needless to point out, automation has boosted the productivity of every industry it has touched.  

Medical informatics and healthcare analytics solutions have repeatedly revealed a drastic increase in productivity and efficiency after automation. In other words, payers can accomplish more with fewer resources and enjoy higher revenues.   

6. Efficient Claims Processing  

Processing the claims is among the most critical aspects of payer operations. Each claim can vary depending upon health plans, providers, type of treatment, medical history, and so forth. Mistakes in this process often result in delays and re-submissions.  

Automating all the monotonous parts of the claim’s life cycle brings enormous efficiency and speed. So much so that it’s known to improve the overall healthcare management on the provider side.  


Healthcare payer automation is a proven technology known to boost revenues, speed, efficiency, and overall patient satisfaction. Hospitals routinely report better outcomes and embellished patient engagement systems after adopting them.   

An automated health system at hospitals has resulted in seamless healthcare interoperability, which helps improve the delivery of care. From population health management to cloud computing in healthcare, there’s not a single area of the medical industry that hasn’t seen improvement after experiencing the wonders of automation.  

Healthcare payer automation is bound to save money and time for insurers and doctors, and it has the potential to eliminate mistakes and cut down denials. Ultimately, it’s the patients who stand to benefit from the healthcare industry’s adoption of this marvel. 

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Ohio Receives 175,000 COVID-19 Test Kits Through Partnership



Columbus, Ohio — Dr. Bruce Vanderhoff, Director of Health, Ohio, announced on Wednesday that more COVID-19 rapid tests will be available in Ohio thanks to the new partnership.

According to the release, the Rockefeller Foundation has participated in six states through the Project Access COVID test, making the test available to homes in poorly serviced areas.

The partnership’s first Ohio quota is 175,000 tests, which will be available for courier.

In its release, Dr. Vanderhoff said Ohio was one of the first states to ensure that free rapid testing was widely available. Over 5 million kits have been purchased and distributed to schools, libraries and community health departments.

“Because of the rapid shortage of tests nationwide, this partnership with the Rockefeller Foundation will help increase access to tests for high-risk people and reduce their spread in our community,” Vander said. Dr. Hoff said.

Ohio receives 175,000 COVID-19 test kits through partnership

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Governor Mike Dewein Discusses New Intel Facility




The project will create more than 20,000 jobs in the state.

Columbus, Ohio — Ohio authorities are discussing incentives in a decision to bring two new Intel chip manufacturing facilities to the state.

The briefing is hosted by Ohio State Development Director Lydia Miharik. You can see it on the following players:

DeWine announced a $ 20 billion investment last week, calling it “monumental news for Ohio.”

The project will create more than 20,000 jobs in the state. This includes 3,000 direct Intel jobs and 7,000 construction jobs during the build process.

Overall, the project is expected to add $ 2.8 billion to Ohio’s total annual production.

“The new plant in Ohio is part of a strategy to increase semiconductor R & D and global manufacturing capacity and restore leadership in the US semi-manufacturing industry,” said Intel CEO Pat Gelsinger. Says. “Intel Ohio expects to become one of the world’s largest semiconductor manufacturing sites over the next decade.”

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Governor Mike Dewein discusses new Intel facility

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Contribution of Verbs to the Webb Telescope Discussed at the Lima Astronomical Society on February 4th



LIMA — Robert Verb presents a $ 10 million James Webb Space Telescope’s beryllium mirror segment process and engineering involvement multimedia program at the Lima Astronomical Society meeting on Friday, February 4th.

The meeting was at 8 pm at 670 N. Jefferson St in Lima. It starts at the Schoonover Observatory in the Schoonover Park.

Verb is a former US Army officer and graduate of the Faculty of Engineering at the University of Toledo. He was responsible for providing the correct chemical mixture, processing the material, and following up with the machining of beryllium mirrors and shipping to NASA.

Lima Astronomical Society: 8 pm, 670 N. Jefferson St in Lima. Schoonover Observatory in Schoonover Park. Robert Verb presents his contributions to the Webb Telescope.

Contribution of verbs to the Webb Telescope discussed at the Lima Astronomical Society on February 4th

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