Management of claims submissions in private health insurance apps

Private health insurance providers offer their policyholders access to top-quality healthcare. As a private health insurance policyholder, you can, for example, secure a doctor’s appointment on short notice and usually also profit from a significantly better range of services compared to those with public health insurance. A major distinction from public health insurance is that with private insurance, medical invoices must first be paid upfront, and then you can reclaim your money through a claims submission and reimbursement process that is sometimes well-organised and sometimes less so. This exact process often causes frustration for customers and thus offers a lot of room for improvement. With Gini Pay Connect, this process can now be handled with greater ease and convenience for customers.

Management of claims submissions: How insurance providers solve this problem

Until now, paying invoices and submitting them to an insurance provider were two separate processes: an exclusive survey by Gini found that around half of insurance policyholders pay their invoices from the doctor, hospital, rehabilitation or therapist online using banking apps or online banking. Furthermore, one in ten people pay directly on-site and around 7% still pay by bank transfer or directly at the bank. It’s not uncommon that invoices are accidentally paid twice or are forgotten, resulting in unpleasant reminders. For those with public insurance, it’s different. They just need to pull out their insurance card and the billing for services is handled automatically between the service provider and the public health insurance.

To put it plainly: until now many private insurance providers have left their policyholders alone to handle the frustrating payment process and this dissatisfaction is reflected in the numbers. Only one-third of our survey respondents expressed high satisfaction with the claims submission and reimbursement process.

Additionally, the reimbursement of expenses by private insurance companies can take up to three weeks or more. In the past, medical invoices were mostly sent by letter to the health insurance provider however, the trend is now shifting towards submission of claims via app/ photo payment. Here, the picture quality is the deciding factor for faster processing by the insurance provider.

How can the management of claims submissions be made customer-friendly?

Currently, customers are facing several pain points i.e. negative experiences, these range from a confusing claims submissions process and a complicated user interface, to unclear policy coverage details, that are sometimes delayed. Moreover, in the worst cases, the insurance provider may not even offer a straightforward way to submit receipts online or via an app without a complicated scanning procedure.

Nowadays, a modern app that fulfils many different functions stands at the heart of customer-friendly management of claims submissions. Gini asked »What health insurance policyholders really want« in its survey together with YouGov Germany and found that over 60% of participants ranked the desire for a better overview of submitted invoices in first place. Following closely were requests for the option to adjust personal information with 59% and an automatic calculation feature for the excess, determining when a submission is worthwhile (55%). In the survey we specifically revisited the claims submission process and found that 37% of participants prioritised the simplicity of the whole process, followed by the speed of the reimbursement.

The importance of a well-functioning and simple app for health insurance providers nowadays is underscored by another impressive figure: 49.6% of those who use an app are also satisfied with their private health insurance, in comparison to 31.8% of non-app users.

From all of these numbers we have drawn some important conclusions: Gini Pay Connect helps private health insurance companies to fulfil customer needs in the ever-important area of claims submission management. With Gini Pay Connect, the payment process of invoices will be, for example, integrated into the private health insurance app. We combine what used to be two completely separate processes into one (include video), saving time and providing customers with the advantage of managing or tracking the entire process, from paying the invoice to submitting it to the private health insurance provider, through to reimbursement, all within one app. Our App2Bank application can already be integrated into the apps of almost all leading banks. Here, the invoice data, previously captured through the photo app, is automatically transferred into the payment form of the banking app. The customer is forwarded from the insurance to the banking app, where they can confirm the payment and is then returned to the insurance app. The status of the whole claims process, up to the reimbursement is then visible in the insurance app – with an optional digital collection and payment folder. It couldn’t be easier!

An optimised claims submission management system offers the following advantages:

With Gini Pay Connect, private health insurance companies profit from many advantages:

• Increased customer satisfaction through increased focus on customer service
• Increased upselling and cross-selling: app users have a significantly higher number of additional insurances with the same provider compared to non-app users
• Convenience features like Gini Pay Connect play an ever-increasing role in gaining new customers
• Creation of additional customer touchpoints
• Automated capturing of the invoice data thanks to the app/ photo payment
• Increased rate of processing of low-light images thanks to AI-based optimisation
• Simplification of internal processes and quicker processing times thanks to higher quality of captured invoice data

Our conclusion: by simplifying claims submission management using Gini Pay Connect, private health insurance providers not only enhance customer satisfaction, laying the foundations for a long-lasting and stable customer relationship, but also boost their business through additional upselling and cross-selling effects. These are not empty claims, as shown by the results of our independent survey.