Understand in this post what accident rate is and how to significantly reduce your health plan provider's percentage in a short time! One of the most important indexes in maintaining health plan benefits, “loss ratio”, especially in healthcare providers, is a term well known by professionals in the field, as it has a major impact on contracts with insured companies.

It is essential that every healthcare operator is aware of this metric, considering that it will have a major impact on the organization's financial management. It is also important that there is efficient work to reduce accident rates and these measures are not as complicated as they seem.

Learn, with this article, what exactly the accident rate is and what to do to reduce its percentage by up to 30%, generating greater stability and guarantees for the healthcare provider.

Enjoy and get to know Saudi a Medical Bill Management System complete to assist you in reducing up to 95% of medical disallowances, avoiding rework costs, improving your diagnosis of several important medical bill audit processes. With the SAUDI system, your health plan operator is on track for the most important thing: significantly reducing accident rates in a SHORT time.

Understand what accidents are

The accident rate of health operators is related to the contracts they have with companies that offer their services to employees of that corporation. This is the relationship between the number of procedures performed by a beneficiary through the health plan and the amount paid to the operator by the contracting company, called premium.

The name accident rate comes from the expression “claim”, which is the term given to the action of carrying out any procedure through insurance, such as consultations, exams, surgeries, etc. The more procedures the beneficiary performs, the higher the accident rate.

Why is the accident rate bad for healthcare providers?

The costs that companies have to maintain a health plan for their employees end up being quite high due to a series of factors.

Even faced with this reality, many organizations take on this account because they know that this is one of the main benefits they can offer their employees.

However, a very high accident rate causes bills to become too high, which motivates many corporations to give up providing this benefit for their employees.

We also need to consider that, in practice, carrying out procedures indiscriminately increases the healthcare provider's costs, impacting the values of the adjustments made by it. And this is yet another reason for organizations to waive the contract.

Ultimately, we realize that the high accident rate is bad for contracting companies, health care providers and, consequently, for beneficiaries, who run the risk of ending up losing their health plan and good service.

Measures to reduce the accident rate in healthcare providers

As we have already mentioned, one of the main missions of healthcare providers who want to keep their financial management under control is to avoid high accident rates.

To make this possible, some measures can be adopted to prevent the insured from making unrestrained use of their health plan, creating an imbalance between claims and insurance premiums. Check below the main actions for this purpose:

Stimulate prevention actions

Most people only seek medical help when their health conditions are somewhat delicate. In these cases, sometimes complex medical intervention, many consultations, many tests, long treatment and even surgical intervention may be necessary.

To avoid situations like these, it is essential that the beneficiary follows a routine of consultations and preventive exams and does not just seek a doctor when they already have serious symptoms. This applies mainly to elderly people who tend to have more delicate health.

By doing this, it will be possible to have an early diagnosis of any possible disease, making treatment easier and faster.

This measure is important not only for operators, but also for the beneficiary themselves, given the importance of a diagnosis in the initial phase of any disease.

Encourage conscious use of health insurance

The health operator can produce informative materials and even hold lectures in order to guide beneficiaries on the most conscious way to use their health plan.

This action will be efficient, both for encouraging preventive actions and for providing guidance on unnecessary consultations, which is very common to occur when the beneficiary does not need to pay anything for the service.

Encourage the adoption of healthy habits

One of the main reasons why people need medical attention is the disorderly lifestyle they tend to follow.

Poor diet, lack of physical exercise, overwork and lack of leisure are some of the elements that make people sick, and encouraging healthy lifestyle habits, in addition to actions that promote well-being, can be an efficient way of helping beneficiaries. to maintain their health in good condition.

Prize value also counts

In addition to actions to avoid high numbers of medical care, there is another very important measure to reduce high accident rates in healthcare providers: compliance with the premium value.

So that there is no risk of suffering easily from this imbalance between the amount spent on claims and the premium, operators must charge a price sufficient to cover the necessary costs of the services and not have any surprises during the course of the contract.

Many operators, especially those entering the market, want to win over customers through price and end up charging a price below that which complies with the services offered.

Faced with this reality, they soon begin to realize that this was not the best path. In this case, prevention is better than cure. For this reason, value definitions need to be very well thought out.

Understanding and knowing how to reduce the accident rate of healthcare providers is essential for professionals in this field, but there are other important issues that need to be considered and understood with regard to operator management.

If you are a director and know how vital it is to reduce accident rates or if you are a medical accounts manager or analyst and are on the front line of this mission, be sure to get to know SAUDI, the most award-winning insurance system. medical bill management and used by the most renowned operators, such as Bradesco, Unimeds throughout Brazil, Paraná Clínicas and many others.

Understand why SAUDI reduces your healthcare provider's claims rate in the first 3 months of use:

Automate medical and administrative audit processes electronically, quickly and reliably;

Optimize process flows by identifying and eliminating bottlenecks;

100% Eliminate the use of paper from processes in your operation;

Zero implementation costs;

Automate medical and administrative audit processes electronically and quickly;

Reduction of accidents, through a marked improvement in claims controls and better contractualization of the provider network.

Are you interested? Wait until you know all the advantages of SAUDI system! ; )