In this article we'll show you how SAUDI, the medical bill audit the most awarded in Brazil, works to reduce the costs of a health operator and you will understand why it can become your main ally.
Supplementary healthcare in Brazil faces significant challenges related to controlling and reducing costs, due to the increase in healthcare resources and the need to improve operational efficiency. In this context, the SAUDI System (Intelligent Audit System) has emerged as an essential technological solution for health plan operators seeking to reduce losses and optimize their processes.
Challenges facing health plan operators in Brazil
In recent years, health insurance companies have faced increasing financial difficulties. In 2022, the sector recorded an accumulated operating loss of R$ 11.5 billion, the worst result in two decades, according to data from the National Supplementary Health Agency (ANS). Factors such as the increase in healthcare expenses, inflation in the health sector and the resumption of elective procedures after the pandemic contributed to this scenario.
The role of the SAUDI System in mitigating losses
O SAUDI System is an automated medical auditing tool that helps operators efficiently manage their healthcare expenses. Its implementation offers several benefits that have a direct impact on reducing costs and improving internal processes.
1. Automation of audit processes
Traditionally, auditing medical bills is a manual process, susceptible to human error and inefficiency. SAUDI automates this function, enabling faster and more accurate analysis of the bills submitted by healthcare providers. This significantly reduces processing time and minimizes the occurrence of errors, ensuring that operators only pay for services actually rendered.
2. Identifying and preventing fraud
Fraud and unnecessary procedures account for a considerable portion of the additional costs faced by operators. SAUDI has advanced detection mechanisms that identify atypical billing patterns, enabling early intervention and the prevention of undue payments.
3. Improved relations with service providers
The transparency and efficiency provided by SAUDI strengthens the relationship between operators and providers. With clearer and more auditable processes, there is a reduction in disputes related to disallowances and payments, promoting a more harmonious partnership focused on the quality of care provided to beneficiaries.
4. Compliance with regulatory requirements
The ANS establishes various regulations that operators must comply with in order to guarantee the quality of the services provided. SAUDI helps them comply with these requirements, generating detailed and up-to-date reports that make it easier to render accounts and avoid possible penalties.
5. Predictive analysis and strategic decision-making
In addition to auditing accounts, SAUDI offers predictive analysis tools that help operators identify trends and anticipate problems. With accurate data in hand, it is possible to plan preventive actions, negotiate better with suppliers and implement health programs that meet the specific needs of beneficiaries.
SAUDI's real impact on healthcare operators
The adoption of SAUDI has shown significant results. Operators who implemented the system reported a significant reduction in operating costs and an improvement in the efficiency of internal processes. In addition, the ability to detect and prevent fraud has contributed to the financial sustainability of these organizations.
Faced with the financial challenges faced by health insurance companies in Brazil, the adoption of technologies such as the SAUDI System has become essential. By automating processes, preventing fraud and improving relations with providers, SAUDI contributes directly to reducing losses and to the sustainability of the supplementary health sector.
Book a demo now and see how SAUDI works to guarantee operational efficiency and the quality of the services offered to beneficiaries.
