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Great Expectations: New Coverage Transparency Rules Forcing Healthcare Insurance Providers to Think Outside the Box

The pressure is on. There are big changes coming to the world of healthcare insurance in 2023-2024, and these changes all require your company to get a handle on its data. The Transparency in Coverage Final Rule, for example, requires healthcare insurance providers to disclose their pricing for covered services publicly. 

On January 2, 2023, the Disclosure to Enrollees requirements will become applicable to some 500 pre-defined healthcare services. In 2024, these requirements will apply to all items or services. Transparency in Coverage Final Rule(s) are forcing healthcare leaders to sift through mountains of data—with no end in sight.

Not only are large organizations struggling to make sense of all the data it must now disclose in public, but turning that data into actionable information for consumers is a second challenge. But there’s a way through it—to process mountains of data and come out looking like a “boardroom hero.” Here’s how.

What the Insured Want: Actionable Data, Not Pure Data

It’s not enough to download all of your relevant data and publish it in incomprehensible tables online. This approach, known as “simple transparency,” won’t cut it with your audience. Consider the difference between offering straightforward transparency and actual, actionable insight the insured can use:

  • Transparency: Raw data. This means posting simple data like raw prices, but without any guidance on how to seek better prices on coverage.
  • Actionable insights: Empowering decision-making. For example, showing customers the existence of a lower-cost medication that might treat the same condition is different than simply publishing the prices and expecting the insured to know what to do with this information.

How an RPAaaS Solution Can Help You Navigate this World With Confidence

Of course every healthcare insurance provider wants to offer empowering information—to not only meet the changing standards of public information in 2023-2024, but to do so in a way that the insured can actually use. What’s the problem? Handling all of that data, and essentially “translating” it for an audience that needs actionable insights as well as price transparency.

Enter RPAaaS, or Robotic Process Automation as a Service. This essentially “outsources” all of the headaches of processing and translating data to make it more actionable and publishable on healthcare insurance provider websites.

For example, we recently came across an organization that found itself overwhelmed with data. The organization was manually entering 160 records per day. When they signed up for M Corp’s RPAaaS, however, that changed to automated bots completing 2,800 records per data—with data fidelity.

Putting the “Hero” in “Boardroom Hero”

Healthcare providers are wringing their hair about how to meet the new data requirements in a way that satisfies the insured. Our RPA solution —the gap between your current obstacle and what it would take for you to swoop in—can help you complete a massive data processing project on-time and on-budget. You’ll become a hero to a boardroom who feared problems coming down the pike.