Even though health plan management systems are adapted to deal with unpredictable environments, the arrival of the COVID-19 pandemic required a departure from conventional practices in hospitals – which, in fact, contributed to previously unthinkable challenges. .

In this article you will learn about these challenges faced and how SAUDI – Medical Bill Audit Systems, enhances the opportunities that incredibly arose with the Coronavirus, in addition to other advantages that technology has brought to this moment.

Read on and understand now:

Understand the challenges that the pandemic brought to health plan managers

One of the challenges that certainly has a direct impact on helping to provide effective care to victims is the organization of a hospital prepared to receive overcrowding in the least harmful way possible. This also requires a quick redesign of the patient care model, considering that the majority of associates will present highly infectious symptoms.

Therefore, hospitals belonging to the accredited network must take some precautions, such as providing an alcohol gel totem for everyone, in addition to separating rooms with windows for care and dividing the entire environment into dedicated wings to receive those who present signs of those who have signs of other diseases.

Furthermore, it was also necessary for health insurance companies to discover other ways to serve users, especially when social distancing was established and people stopped looking for hospitals and routine consultations for other pathologies.

This attitude, which also helped to ensure the physical and mental health of doctors and nurses, was also linked to the financial loss resulting from the cancellation of routine appointments and elective procedures that helped make ends meet.

As a result, many health plans had to invest in telephone services, teleservices and, above all, recruit a team ready to deal with all the needs that were no longer in the physical field of a standard consultation.

Some health plan managers even followed this example and created their own line to assist patients with COVID at the first symptoms, with a doctor who would assess the severity of the condition over the phone and indicate the need for emergency care – like 136 , created by the Ministry of Health.

Another relevant point were also the challenges faced regarding exams to find out whether those accredited were contaminated. Initially, there was controversy surrounding which tests would be covered by the amount, which would be reimbursed and which would be denied. Despite many injunctions and discussions, it was possible to reach an agreement.

Discover the opportunities generated during this period

The crisis gave opportunities to show the entire population life as it is: unpredictable. And such adversity, of course, highlighted more than ever the need for a health plan for these emergency moments, especially when most public hospitals had full beds.

To give you an idea, the awareness around this was so great that a survey carried out by National Supplementary Health Agency (ANS) revealed a greater demand from beneficiaries for agreements.

Furthermore, when also observing the data on small and medium-sized healthcare operators, according to the ANS, it is possible to see that of the 181 operators that contributed to the analysis of the research in question, 72 companies reported the same trend in their management.

What trend would that be? The drop in accident rates, the improvement in cash flow and the control of default rates, which indicates an effort by the population to meet the financial commitment, even in periods of extreme crisis throughout the country.

Another possible point of view to observe is the emergence of new models of outpatient care, such as telemedicine. This practice, despite being challenging, was intensified with the aim of guaranteeing the safety of uncontaminated patients in hospitals and also ended up contributing to the agility of care.

In fact, this connection tool encouraged greater convenience for healthcare companies to offer their customers a series of dedicated applications for this purpose. Thus, using this technology, they could make appointments, have more detailed information about the appointment and even enter a video call with the doctor through the platform. Have you ever thought about how practical this can be?

Furthermore, another very important issue was the visibility focused on the mental health of the population. In a time of collective stress and the need for social isolation, the incentive to search for professionals focused on this area proved to be more present.

Considering that, according to the World Health Organization (WHO), Brazil is considered the most anxious country in the world and 12% of the population deals with depression, it was possible to notice that the pandemic increased this number alarmingly, reaching 80% and 90% respectively.

Therefore, despite being a cruel rate, such percentages helped health plans to pay attention to health that goes beyond the physical field, opening up opportunities for members to have broader access to therapists and psychiatrists. A victory for those who need it and needed to deal with a limited number of sessions, as well as a time limit for assistance.

Find out how technology can make a difference

Without a doubt, the internet has been an ally for all professionals working in this area, as it facilitates the sharing of information in real time, optimizes processes and creates secure connections between doctor and patient.

With this in mind, SAUDI helps managers, analysts and auditors of medical accounts with software designed especially to maintain the financial health of operators. With it, it is possible to automate the process of auditing accounts between organizations and service providers. Everything in a simplified and agile way, from requesting authorization for medical procedures to release for payment.

The beneficiary's app supports online scheduling of appointments directly with the client's closest accredited network. In this way, our platform reduces unnecessary costs and helps healthcare companies deliver the best results to their patients through quality management of care costs. Interested?

Access our website To find out more, subscribe to our newsletter to stay informed and contact us to find out what SAUDI can do to make your medical bill management as efficient as possible.