Integrated platform to facilitate health insurance claims in Singapore

Integrated Health Information Systems, General Insurance Association Singapore, and Life Insurance Association Singapore are collaborating to develop an integrated platform that enables faster processing of hospitalisation claims. Proposals have been called to develop the platform. Upon its completion, policyholders from participating insurer Great Eastern will be able to use the platform in a pilot before being scaled nationwide. 

HOW IT WORKS

Through this platform, healthcare providers will be able to retrieve details of a patient’s policy coverage for Integrated Shield Plans and group hospital or surgical insurance. Subsequently, this information can be used to determine if their admission deposit can be waived. Patients can use their SingPass, the country’s national authentication system, to digitally authorise the release of data such as medical history and details on insurance policy coverage to insurers and healthcare providers respectively.

Claims processing is also hastened as healthcare providers can submit claims digitally to insurers on behalf of patients via the platform. Additionally, the platform can be used to provide prompt bill information and details about a patient’s status, such as their length of stay in the hospital, to patients as well as insurers. Insurers will then be able to provide faster updates on the estimated claimable amount. 

THE LARGER TREND

Technology companies across the globe have engaged in strategic partnerships to streamline the claims process for health insurance. In the United States, for example, electronic health record vendor (HER) Cerner partnered with insurance company New York Life to provide secure access to EHRs, accelerating underwriting decisions and simplifying the application process.  

Two healthcare technology providers in Singapore  – DocDoc and SpesNet – have also collaborated to develop a comprehensive digital health ecosystem which will provide cashless and integrated claims processing to insurers.This newly developed platform will allow for the matching of policyholders to relevant healthcare providers which enhances their claims processing. Providers are able to quickly ascertain if a policyholder is eligible and if the benefit covers the pending claim, effectively preventing any claim related disputes. 

ON THE RECORD

IHiS assistant chief executive Guai Eng Chun mentioned that the insurance claims process for patient care has been largely paper-based due to the need for information exchanges between multiple systems by various healthcare institutions and insurers. “This may take up to months and inconvenience patients,” said Guai, who added that the integrated ecosystem will bring more convenience to patients and speed up the end-to-end claim process.

LIA Singapore executive director Pauline Lim said, “This cross-sector pilot programme reflects the insurance industry’s commitment to digitalise to future-proof its ability to meet increased patient demand by enhancing the end-to-end hospitalisation experience.”

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