In Focus: Vulnerability  

How tech can help your clients to claim

  • To understand the constraints on medical claims processing
  • To ascertain how technology is being developed to help the process
  • To be able to explain how best to approach making a claim
CPD
Approx.30min

Data might include age group, gender, medical conditions, and so on.

It has to be manageable, and that means it has to be structured data and compatible with existing clinical codes, such as SNOMED CT, ICD9 and ICD10 - in other words, the technology that facilitates transfer between GP practice and insurer has to be compatible.

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A technology platform that uses a compatible language, facilitates a standardisation of the aggregated data and easier access and sharing.

The future

The future involves the consumer more fully, with the consumer at the centre of the process.

Multiple sources of health information together with access to the patient’s GP record data will be able to contribute to one central source.

For example, adding wearable technology holds a host of information on an individual’s diet, exercise, health and fitness, and this can feed into one central place.

Today, people don’t just access healthcare from the NHS via their GP, they may combine this with support from other private clinics such as physiotherapy and osteopathy. Pharmacies increasingly deal with patients directly.

This can all be fed into one repository, which the individual controls. Individuals won’t be able to edit the information from these third parties, but they can give authority over who can contribute and what is shared.

AI and machine learning will intuitively present a data set dependent upon who is requesting the information from the patient.

This will all help to build as full a picture as possible about a person’s health and wellbeing. This will mean that underwriting can be more accurate and dynamic, and it can feed into product development ensuring that products are relevant to the individual.

Technology also helps to support vulnerable customers. Anyone can become vulnerable, and it might be a permanent or a temporary situation. For instance, it can be a result of bereavement, a diagnosis of illness or sudden change in circumstances.

Products and processes that have transparency and put the client at the centre are particularly helpful for vulnerable customers, and technology enables this.

So the current process for accessing customer medical information is clunky and unhelpful. eMR technology solves this issue, and this has immediate benefits in time savings and efficiencies which benefits the whole distribution chain, from GP practice to insurer to individual.

It also has much wider benefits in terms of customer experience, pricing and product development. This technology exists, it’s bringing great efficiencies and the potential opportunities are game-changing.

Richard Freeman is managing director of medi2data

CPD
Approx.30min

Please answer the six multiple choice questions below in order to bank your CPD. Multiple attempts are available until all questions are correctly answered.

  1. According to the author, what is falling on fewer shoulders?

  2. Freeman gives four attributes of great technology. Which of the following are not one of them?

  3. Latest platform developments mean a medical report can be turned around in how many days now?

  4. Freeman claims advisers can be tempted to chase whom when there are delays?

  5. True or false? Freeman says it’s better that underwriting is embraced - and made more efficient - than circumnavigated.

  6. What is bad for the client and the whole industry, according to Freeman?

Nearly There…

You have successfully answered all the questions correctly, well done!

You should now know…

  • To understand the constraints on medical claims processing
  • To ascertain how technology is being developed to help the process
  • To be able to explain how best to approach making a claim

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