Benefits to the Public Sector
Benefits To The Public Health Insurance Scheme Administrator:
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In many countries the Public create and administer their own health plans. PAS in an ideal solution in such locations because it offers the public sector administrator all of the benefits and savings enjoyed by insurance carriers, at a fraction of the costs associated with outsourcing.
Benefits To The National Health Plan Administrator
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In addition, some countries like Jamaica offer a National Health Plan which reimburses its citizens for drugs (according to the price of the corresponding generic item), used to treat some 16 chronic diseases. Drug treatment schedules can be set up for each disease within the PAS database, and the system is updated with appropriate information when a citizen is certified by an appropriate physician, as having one or more of the pre-defined chronic diseases. The citizen is issued a magnetic strip I.D. card, which is required to initiate a claim at participating pharmacies. PAS handles all of the monitoring thereafter, ensuring that there is no abuse and that no one gets more or less than they are allowed under the program.
Benefits To The Public Sector Hospital
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Some Public Sector hospitals adopt a policy of not refusing service to a patient who is unable to pay. This is noble, yet expensive (and at best, difficult to monitor). Experience has shown that many who profess an inability to pay, are in fact being deceitful. Some have undeclared insurance policies, while others are financially able.
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PAS, with the permission of participating insurance carriers (and this can be encouraged), will transmit a name enquiry through to the various databases to establish the health insurance status of the relevant patient. Hospitals should be advised that cooperation is not likely (from insurance carriers or from patients), if higher rates are charged to those "with means."
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PAS, being an online system, can be directed to communicate with other databases that the Public Sector may have, to establish "means." This liability to the Public Sector can be logged in important databases where "more leverage" in the collection effort can be exercised.
PAS, if installed with the optional Accounts Receivable module, will automatically charge such unpaid sums to an account established in the name of relevant patients. This information can be used for future follow-ups, and outstanding balances will be prominently displayed on the patient's next visit.
Click on a link
below to read more about the specific benefits of PAS.
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Benefits to the Public Sector
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