HOW TO MAKE A Medical Insurance APP?

The mobile app development for health care looks increasingly like a potentially useful idea. 2020 is definitely the year that’s bringing innovation to the electronic wellness area, so in this period of unprecedented medical crisis, the demand for safe and usable health solutions — and health insurance mobile apps especially — becomes an essential component of the procedure.

The mobile health (mHealth) market is booming worldwide.  Recent research predicts its dimensions will reach USD 57.57 billion by 2026, demonstrating a shocking сompound annual growth rate of 29.1percent between 2019 and 2026. In any case, because mHealth is an umbrella term covering the general practice of mobile-supported general health and therapy management and health insurance is for many people the only way to get health care services, it is going to be safe to say that the changes in mHealth will necessarily affect, amongst others, the way medical insurance services are supplied.

Because of strong customer demand, mHealth apps are expected to observe a surge in the growth rate during the next few decades, changing such business segments as health monitoring, health management, diagnostics, therapy, and health insurance. Keeping pace with another mHealth fields, the worldwide medical insurance market is also anticipated to grow. By 2026, it’s estimated to reach $4,475 billion, expanding at a CAGR of 4.4percent from 2019 to 2026. This universal up trend suggests that it’s the ideal time to do it and grab the chance to make health care more accessible to countless people.

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In our article, we’re going to talk about what health insurance mobile app models are there on the market and what benefits these applications can bring to patients and insurance companies. We’ll also look into what measures to take when creating your own medical insurance app, how much it may cost, and what businesses to take under account, building your project plan.

Health insurance mobile app models

The degree of public and private medical insurance policy differs from country to country. Some insurance systems are more challenging to understand than others. In light of this, a health insurance mobile app can turn into a smart personal assistant that would make life a bit (or a lot, it depends) easier for a patient, a health care provider, and an insurance provider.

    • A medical insurance policy patient app – Patients require a means to readily access possibly the most important information related to their general health. A medical insurance policy app usually functions as a digital file cabinet that stores organized patients’ medical records, including information on health insurance claims processing and advantages. Connecting insurance-related data from various sources in one area, a mobile application allows users to spend less time managing their health and more time living life. This is only one advantage of a medical insurance policy app for patients, and we’ll soon start looking into what else it can provide users.
    • An app for health care providers – By creating an app for healthcare providers, it is possible to enable them to draw any info they require from one source. Assessing if the documents are legal, if a patient is eligible to direct billing, and much more — a medical insurance app will incorporate new technology as part of the health care digitization travel and make the regular routine associated with the handling of insurance issues less burdensome. Medical providers require a technical solution to get things done in an agile way. Collaboration is critical, and it may be preserved by using an insurance policy app for health care providers.
    • An app for those procedures inside insurance companies – Though insurance as such is an extremely traditional business, the technological shift continues to be exerting more and more influence on it within the last few years. The need to keep the coverage affordability, within this context, remains one of the primary drivers for all of the actors in the medical field. Specifically, it makes insurers develop the agility and flexibility required to warrant the patients covered are fulfilled and get help when needed. To navigate the complexities this may entail, insurance businesses require a medical insurance policy app.

The benefits of health insurance apps

As we may suspect, health insurance mobile apps can benefit patients, medical providers, and insurance providers equally. For now, let us focus on what benefits such applications introduce into the lives of individuals and insurance companies.

Benefits for patients

1. ) The choice of in-network professionals obtained within minutes  – Access of information about physicians within a mobile app is a very big plus for patients. The users will just have to have a few taps on the screen of the smartphones to get the ideal supplier that would fit the specified criteria. The insurance coverage means you always have to keep track of if the experts you see are in-network ones so the appointment might be covered by your insurer. It’s a really sensitive issue, particularly given that in the united states, the proportion of plans that provide out-of-network benefits has dropped significantly from 58 percent in 2015 to 29 percent in 2018, and the downward trend persists.

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Clients of medical insurance companies normally don’t have any idea if the physician that they are sent or referred to is available under their current plan. The medical insurance app, then, can offer you comprehensive information regarding the price, quality of service provided, and if the facility can accept your insurance.

2. ) The general transparency of the medical system – As a rule, a medical insurance app offers full data transparency and visibility, providing users access to all insurance-related info on a single dash. The app for medical insurance can serve as a convenient data storage in which data is collected and stored in a protected, up-to-date, and consistent way. The customer mobile app offers healthcare beneficiaries with greater transparency of the health information and makes it easier for them to be deeply involved in their healthcare choices.

Visibility to the used benefits, deductibles, claims documents, and much more in an electronic format also means the elimination of the excessive paperwork, which lets one take an unbiased look at the circumstance. The possibility of downloading a digital version of the claims records and fitting them with other health records enables healthcare beneficiaries to control their healthcare information better. Anyway, they will most probably be the people who can allow or restrict access to this information and choose to share it with others.

3. The good foundation for cost reduction – Medical insurance applications give immediate access to a suitable policy choice, which opens up a possibility of substantial savings on health care services for people. An application can help compare unbiased and personalized recommendations based on a patient’s health and earnings, monitor their policy and medication prices. Ideally, a user has to have the ability to configure alarms to get alerted whenever some crucial change in their strategy, policy, or pricing is detected. Anyway, a mobile app is a wonderful means for accessing discount coupons and assorted cost-saving offerings delivered directly to the user’s inbox.

Personalized recommendations provided within a health care insurance app is something which guarantees a specific user gets the advice he or she needs and deserves. Then, when a user fully understands the available alternatives, he or she becomes empowered to make wise decisions, leading them to health care services and medication costs reduction.

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Gains for insurance

1. ) Automation of business processes – Modern tools built into medical insurance applications can automate processes, easing the impact of inefficiencies and optimizing both employees and systems utilization. Applied wisely, they need to turn out instrumental in simplifying internal IT structure and establishing standardized procedures.

Simplification of complex workflows and acquisition of the perfect information for optimal decision-making are among the anticipated positive outcomes of automation. Modernization of these legacy systems may cause an increase in the amount of transactions handled and the quantity of papers generated in an electronic format daily. Then, companies will have the ability to concentrate on customer retention, acquisition of new customers, new product delivery, and quality assurance of the services they supply. In any case, paper removal and focus on case management automation may support the cost and compensation timeframes reduction.

2. ) Customer base expansion  – Automation of these procedures associated with insurance services delivery also leads to overall customer management advancement. Powerful and efficient technology-enabled customer support is simpler to make sure when all the vital data could be accessed and managed via the power of their back-office functions. Critical information such as information on policy processing, billing, or claims must be easily available when an insurer functions on a case or communicates with a customer.

Obviously, the amount of individuals utilizing the insurance app increases. However, the medical insurance app must do a little more than simply exist to aid insurers reach wider audiences. The medical insurance application for insurance companies has to be designed in this way to reduce client request-response time, optimize turnaround time, improve consistency, and provide all of the crucial metrics that enable assessing customer service quality.

3. Ongoing on-demand communication – When it comes to health insurance, superior customer experience is closely related to the continuous communication between a client and an insurer. Not only does this increase the consumer experience, but in addition, it helps retain current clients. Supported by medical insurance apps, insurance companies will have the ability to keep a continuous connection with patients and respond to their queries on-demand.

Chatbots are an alternative option that could give users the support they need when no insurance broker is available to explore an occurred issue. Chatbots are there round the clock and enabled by AI technologies like voice or text recognition. Furthermore, this technology keeps evolving, so the quality of the answers provided is bound to improve as well.

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The phases of health insurance app development: Things to bear in mind

Regardless of which sort of health insurance app you will eventually go for, the app development process will inevitably comprise the three major phases: applications development, compliance assurance, and product testing, followed by its release. Let’s address each one of the measures individually and talk about what aspects deserve a more comprehensive consideration from the project staff.

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1. ) Designing your medical insurance app

    • Health insurance plans comparison – It shouldn’t be necessary to turn to the employer, government, insurance provider, or agent to have the list of available health insurance options and select the coverage. So that this choice wouldn’t impact your wallet in the long run, it’s important to comprehend the differences between plan types, whether it’s your first time buying health insurance or another effort to switch plans. A medical insurance policy app can educate you about the advantages and disadvantages of various coverage options, let you compare them unbiasedly, and pick the one which matches the needs best.
    • Claims management – One of the basic benefits of a medical insurance app is immediate access to health care data. The viewing, hunting, and bookmarking of claims quickly must ease the medical records management for one user. Meanwhile, the ability to publish, review, and examine the status of pending claims from far and near, just using a smartphone, can develop into a true game-changer for many clients. Streamlined claims-related operations, in addition to customized and automated workflow, should be visualized on an improved user dash so that consumers paying claims for them and their families may be sure they won’t miss anything.
    • The renewal or purchase of a medical insurance plan – After a perfect medical insurance plan is found, it has to be paid. When the coverage period ends, the insurance must be renewed to maintain that coverage active and enjoy constant coverage. A medical insurance policy app for Android and iOS must facilitate those procedures. Clients will probably expect that insurance renewal and purchase will follow a straightforward and quick procedure when done online. So, app providers can’t but meet the expectation. Allow users to review renewal conditions, prompt them to check out other possibilities, and remind them to renew their policies prior to the due date.
    • Payments direction  – Strategy purchase or renewal demands reliable methods of working to ensure accurate payments. Complete and accurate information is crucial in billing and payment processing. It will help lay the foundation of excellent consumer experience in users’ health care relationships. In this respect, the best health insurance app has to be flexible in regards to the billing solutions it provides. Afterward, it will able to rapidly and correctly enroll new members, streamline invoice processing, handle complex contractual and payment connections, ensure correct adjustments, and provide adaptive calculations for incentives and commissions.
    • Search for in-network healthcare providers – Locating in-network suppliers nearby by specialty or location is a possibility that a medical insurance app must provide to its customers. Different health insurance programs include unique health benefits, in addition to exclusions and limitations. The assortment of medical care specialists whose services can be paid for by a given policy is limited in an individual manner, also. So, the ability to find in-network urgent care centres or other facilities when they’re needed can be an immense cost saver. As a bonus, you may add access to the current waiting period at different in-network suppliers, hours of operation, driving instructions, and a health care facility’s contact info.
    • Placing and rescheduling appointments – Following a patient finds a supplier who they may safely establish an appointment with, administrative agreements should follow. To reserve appointments for themselves or somebody else, consumers need to be given an easy step-by-step manual on submitting requests with a mobile medical insurance app. As the situation can change any moment, patients must be permitted to make alterations to their forthcoming bookings or cancel them inside the app.
    • Search for drugs and drug prices comparison – There are a significant variety of mobile applications that promise to lower your costs at the pharmacy counter. However, why not give users an all round solution? Therefore, you buy an insurance program, locate a health care provider, reserve an appointment, and then use the exact same app to look for the prescribed drugs at the lowest price possible on the industry. Convenient, is not it? Also, money-saving suggestions, information about benefits programs, search by location, detected using GPS or entered manually, and much more — the experience of buying prescribed medications can be improved.
    • Lab results direction  – A health insurance mobile app can go so far as to allow users to securely track their laboratory results. Turn your goods to a fully-fledged insurance-focused electronic health record. Labwork, X-rays, along with other newspapers that individuals get after their appointments are important documents that need to be readily accessed in the app. By way of instance, it should automatically place doctor’s appointments, in addition to the forthcoming lab tests, on the individual’s device’s calendar.

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2. ) Fitting the present health laws

Legislation is still one of the most difficult areas of the medical insurance industry. Compliance demands from national, state, and other regulatory bodies are rising. So, it’s very important for organizations to keep abreast of regulatory changes. These are the important regulations that each and every medical insurance policy app provider must ensure compliance with.

    • HIPAA and HITECH – The Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH) are the two main documents for the digitized healthcare industry in the USA. HIPAA covers information about an individual’s health or health care services classified as Protected Health Information (PHI). The HITECH Act further expands those security and privacy protections, introducing increased legal liability for non-compliance and extra enforcement activities, specifying compliance requirements for business associates, and much more.
    • GDPR – the General Data Protection Legislation (GDPR) is the principal regulation on data protection and privacy in the EU. It designates health, genetic, or biometric information as a special category of personal data that have to be given additional protections. GDPR describes clearly under what conditions digital apps, health-related ones, amongst others, process user information lawfully and what could be regarded as a breach of privacy.
    • PIPEDA – Personal Information Protection and Electronic Documents Act (PIPEDA) is the essential data security document for Canada. PIPEDA healthcare data restrictions really mimic the compliance criteria laid out in the US HIPAA, and all Canadian customer personal data falls under its jurisdiction. Although PIPEDA applies to all consumer information rather than just to healthcare-related data, violation of the act by a medical insurance policy app provider will inevitably launch a formal investigation and might lead to penalties of up to $100,000 CAD.
    • PCI-DSS – Payment Card Industry Data Security Standard is a global information security standard which needs compliance from associations processing payment card data as part of the operations. All companies must follow along with secure and protect cardholders’ credit card information and other information transmitted through card processing transactions. In a way, PCI and HIPAA have certain similarities, and by ensuring compliance with PCI-DSS, an individual will most probably also obey the encryption requirements set out in HIPAA.
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3. Testing and releasing your product

The above two measures should lead one to the point at which the developed product’s grade has to be assessed before the application is released to the general public. After the strategy we described, you’ll have the ability to create several medical insurance apps — for patients, health care providers, and insurance providers. And the wider spectrum of jobs this app will cover, the more thorough the testing procedure will be. It’s also the ideal time to consider how you will communicate with customers and how you are going to provide updates for goods to eliminate the arising vulnerabilities and flaws.

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The best apps to control health insurance

When it comes to successful real-life examples of how health insurance apps can be developed, there are a few cases which needs to be considered. They focus on different facets of providing healthcare services using a mobile app but definitely have made the perfect call and are now big players in the marketplace.

1. ) Aetna Health – Aetna is a huge supplier of health insurance in america. The Aetna Health App is your business’s all-in-one resource which allows patients to search for physicians, in-network suppliers, experts, and walk-in clinics, control the status of the claims, coverage, and costs, manage their prescriptions, and keep current with their benefits. The Aetna Health app is free to download in either the App Store and Google Play.

2. ) Zocdoc – Zocdoc is a handy insurance checker which can be accessed directly on the consumer’s smartphone. It’s a digital health market that countless individuals use to find a physician who will accept their insurance, get significant checkup reminders, fill out waiting space types online and book appointments depending on the available appointment times and other users’ confirmed reviews. The Zocdoc physician booking app is currently the market leader, similar to what Yelp is for restaurants or TripAdvisor for holiday travel.

3. Oscar Health – Oscar is a direct-to-consumer medical insurance firm founded in 2012 in New York. Their mobile app Oscar Health is an electronic solution on both the Android and iOS devices which, as of 2020, is used by over 400,000 members in america. Using the app, patients can see their health history and talk to a personalized Concierge team. The business operates in b2c to provide services to people who don’t have insurance coverage through the employment contract. The business aims at maintaining employer-defined plans from the medical industry so that more customers could turn to Personal Coverage Health Reimbursement Arrangements.

Conclusion

Health insurance is a business that’s open to innovation. Health insurance app development is among the optimal solutions which may help improve involvement, quality of care, and overall customer experience. As you can see, this procedure involves a lot of moving parts which need to be cared for. But with a well-versed and skilled staff on board, everything is possible!

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