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Dynamic Case Management Digest

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Reducing Risk with Underwriting Case Management

  
  
  

You would probably agree that excellent medical case management is an essential service forrisk management “making up the difference” when it comes to insufficient care for those with persistent or chronic illnesses. There’s no doubt that it lifts a huge burden off the older alternatives for treatment and extensive rehabilitation programs supported by the admitting health care institutions, which were slowly faltering under the weight – and often providing insufficient care anyway. Although case management has succeeded in lifting that burden, without insurance underwriting and dynamic case management technology, it can become a new burden for you because of the many vagaries of health care.

Insurance Underwriting as an Aid in the Assessment Phase

The best defense against both insufficient resources for a patient’s long-term care – as well as useless expenditures – is simply preparation. The assessment phase will gather medical history from all available sources to aid the insurance underwriting process and minimize waste; an initially mild health case with a strong family history of diabetes, for example, could encourage becoming insured for its eventual onset given other present medical factors, instead of being unprepared for it should it happen. The risk will be covered properly, uninsurable risks will be made abundantly clear, and suitable deductibles will be applied. In short, insurance underwriting drastically reduces your risk, allowing you to earn a reasonable profit while providing adequate coverage commensurate with regulatory requirements for applicable patients. It stands to reason, then, that the optimal program of insurance underwriting would be that could be managed to reduce risk and error as much as possible.

Insurance underwriting provides the practical, economic (and there are few things more practical than finances) side to the case management suite of duties. Family assistance, rehabilitation assessment and the outlined process must all walk hand-in-hand with applicable funding for those endeavors. Insurance underwriting also presents the patients with an understanding of their level of risk, which has the added benefit of letting them know the steps that they can take to minimize these; if not for them, then for family members and friends, etc. Just as importantly, you can now stay abreast of your competition, which helps you remain capable of insurance underwriting in the first place. This symbiotic relationship is determined by market forces, and represents the only way the two superficially disparate goals can coexist.

Protecting Yourself with Insurance Underwriting

In addition to eliminating moral hazard, insurance underwriting ensures that those that have a reasonably good chance, as determined by law and ethics, of benefiting the most from long-term rehabilitative care end up doing so. An uninsurable risk is, by definition, a drain on resources and ultimately would tear the entire system asunder if allowed to persist due to shoddy insurance underwriting practices, or lack of keeping up-to-date in the meeting of contractual obligations in the case of the insured. Both scenarios require dedicated programs to oversee operations.

Improve Underwriting with DCM

In fact, it has gotten easier to extend the efficacy of your risk management directives with the emergence of cloud-based case management software. As an underwriter, nothing takes away from your bottom line as much as human error, which is generally an acceptable – or maybe merely accepted – degree of loss. The easy and constant accessibility; as well as the comprehensive oversight of all the support actions instrumental in making you as efficient as possible, makes cloud-based risk management software an investment with a considerably high ROI – which would be felt immediately. It is a necessary fact that insurance underwriting reduces risk in case management and is a necessity rather than a secondary consideration.

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Rapidly build and deploy Dynamic Case Management Applications in the Cloud with AppBase, Eccentex's Platform-as-a-Service. Visit www.eccentex.com to learn how to increase business agility, improve productivity, optimize case outcomes, and reduce risk with a cloud platform.

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