Deciding whether to build or buy a system for insurance capture and benefit verification automation is a critical consideration in light of the significant costs and inefficiencies associated with current manual systems. Each year, the healthcare industry grapples with substantial losses totaling $262 billion due to insurance denials, potentially increasing expenses per claim by $30 to $71. Despite the potential recovery of 66% of denied claims, a staggering 65% remain unresolved, underscoring the shortcomings of outdated verification methods.

Organizations facing this dilemma typically have two primary options: developing an in-house automation system or engaging external expertise. Building an in-house system entails considerable initial and ongoing expenses. Initial costs encompass designing, testing, and implementing the system, which can easily escalate into hundreds of thousands of dollars. Furthermore, ongoing maintenance, updates, and enhancements can further inflate these costs over time. The development timeline can span several months to years, contingent upon the complexity of the system and the organization’s specific requirements. 

Build vs Buy

However, the decision to build an in-house system offers distinct advantages, including ownership of the technology and the ability to tailor it precisely to meet the organization’s unique needs. This customization facilitates seamless integration with existing workflows and ensures adaptability to evolving operational demands. While choosing a pre-built system mitigates some development risks, careful evaluation of vendors is essential to ensure alignment with organizational requirements and goals.

This is where the system designed by Orbit comes into play. By harnessing cutting-edge technology and tapping into a vast repository of data that includes thousands of insurance plans, Orbit is adept at performing rapid coverage verification. This capability is transformative for healthcare providers, enabling them to ascertain insurance details in mere seconds rather than the hours or even days. Orbit’s strength lies in its ability to offer a customizable solution while maintaining proven effectiveness. 

The advantages of Orbit’s automation are manifold. First and foremost, the system delivers substantial cost savings. Traditional insurance verification processes often involve significant labor costs and administrative overhead. By automating these tasks, Orbit reduces the need for extensive manual input, thereby cutting down on labor costs and minimizing the risk of human error. Additionally, quicker verification helps prevent delays in patient care and reduces the number of denied claims, which can be costly and time-consuming to rectify.

Moreover, Orbit enhances overall operational effectiveness within healthcare settings. Its rapid verification capabilities streamline workflows, allowing healthcare providers to process claims and handle patient interactions more efficiently. This efficiency not only speeds up the revenue cycle but also improves the patient experience by reducing wait times and administrative burdens.

In Conclusion

Whether an organization chooses to develop an in-house system or opt for a pre-built solution like Orbit, the overarching objective remains constant: harnessing technology to optimize insurance verification processes. Orbit exemplifies a contemporary approach to tackling the complexities of insurance verification, promising accuracy, efficiency, and cost-effectiveness in healthcare administration. By leveraging its advanced capabilities and user-centric design, organizations can position themselves at the forefront of innovation, driving improved patient care outcomes and organizational efficiency in an increasingly dynamic healthcare landscape.