Symbility Health Produces Mobile Health Claims Application for Smart Devices
Written by Alyssa Clark
Symbility Health Produces Mobile Health Claims Application for Smart Devices
With the recent all time high of Medicare, insurance and other types of healthcare industry affiliated fraud, how safe do you feel? Symbility Health asked themselves this same question and it resulted in the creation of a new mHealth app: a claims application that can front-end audit in order to ensure protection from potential fraudulent activity for the everyday customer.
As the industry tries to buckle down amiss the fraudulent storm sweeping through the healthcare industry, Symbility looks to better accommodate patients to ensure their security and their respective financial positions. A division of Symbility Solutions Inc., Symbility Health unleashed the first-ever health claims mobile app in hopes of improving the adjudication process throughout the industry. As a cloud-based smartphone and tablet ready claims app, user access and a more efficient workflow are the two goals sure to be met by this latest mHealth adaptation and it’s as easy as the click of a button.
Both Apple and Android savvy, and free to download from either Apple’s iTunes Store or the Google Play marketplace, this application is set to accommodate a wide variety of smartphones and effortlessly integrate into the already in place adjudication system to allow for real-time claims processing. Not to rely too heavily on technology, Symbility Health is ensuring extra caution to app-users by making sure that high-risk claims are reviewed both electronically and by hand. Symbility Health understands that sometimes the old fashioned way can be soothing to some customer’s strict tendencies concerning financial matters, and this second step in the process is built in to reassure those worrisome consumers.
Being user-friendly and cost-effective are not the only positives of using Symbility’s application, it also acts on your behalf as your own personal financial adviser to caution against the overly-complicated world of insurance. Providing a way to virtually audit takes away the aches and pains of traditional auditing techniques, and better suits the customer’s daily life. The ability to personalize and take the application with you everywhere you go, helps patients feel better about their chances of remaining “fraud free”— and that surely is the way the customer wants to be.
"I am very excited to launch this groundbreaking product that will simplify the adjudication process for our stakeholders and their customers by ensuring that all claims are electronically audited," commented Richard Adair, President and COO, Symbility Solutions. "The best-of-breed nature of our Mobile Claims application will take online claims submission to the next level. Symbility Health designed an easy-to-use app with a proprietary front-end audit functionality that will transform the health claims cycle by offering convenience, efficiency and, above all, time-saving capabilities."
Other added benefits of the application are: easy integration with existing auditing platforms, patent-pending front-end audit capabilities (ensuring that high risk claims are viewed by hand), ability to complement existing consumer mobile apps used by existing members and access through both Apple and Android servers. With all of these added bonuses, it looks like this application will have its work cut out for it as ever-changing technology continues to push more and more business its way.
About the Author
Alyssa Clark is the Editor of Healthcare Global
Getting ready for cloud data-driven healthcare
As healthcare continues to recognise the value of data and digital transformation, many organisations are relying on the cloud to make their future-forward and data-centric thinking a reality. In fact, the global healthcare cloud computing market was valued at approximately $18 billion and is expected to generate around $61 billion USD by 2025.
At the forefront of these changes is the rapid adoption of cloud-based, or software-as-a-service (SaaS), applications. These apps can be used to handle patient interactions, track prescriptions, care, billing and more, and the insights derived from this important data can vastly improve operations, procurement and courses of treatment. However, before healthcare organisations can begin to dream about a true data-driven future, they have to deal with a data-driven dilemma: compliance.
Meeting regulation requirements
It’s no secret that healthcare is a highly regulated industry when it comes to data and privacy – and rightfully so. Patient records contain extremely sensitive data that, if changed or erased, could cost someone their life. This is why healthcare systems rely on legacy technologies, like Cerner and Epic EHRs, to manage patient information – the industry knows the vendors put an emphasis on making them as secure as possible.
Yet when SaaS applications are introduced and data starts being moved into them, compliance gets complicated. For example, every time a new application is introduced into an organisation, that organisation must have the vendor complete a BAA (Business Associate Agreement). This agreement essentially puts the responsibility for the safety of patients’ information — maintaining appropriate safeguards and complying with regulations — on the vendor.
However, even with these agreements in place, healthcare systems still are at risk of failing to meet compliance requirements. To comply with HIPAA, U.S. Food and Drug Administration 21 CFR Part 11 and other regulations that stipulate the need to exercise best practices to keep electronic patient data safe, healthcare organisations must maintain comprehensive audit trails – something that gets increasingly difficult when data sits in an application that resides in the vendor’s infrastructure.
Additionally, data often does not stay in the applications – instead healthcare users download, save and copy it into other business intelligence tools, creating data sprawl across the organisation and exposing patient privacy to greater risk.
With so many of these tools that are meant to spur growth and more effective care creating compliance challenges, it begs the question: how can healthcare organisations take advantage of the data they have without risking non-compliance?
Yes, healthcare organisations can adhere to regulations while also getting valuable insights from the wealth of data they have available. However, to help do this, organisations must own their data. This means data must be backed up and stored in an environment that they have control over, rather than in the SaaS vendors’ applications.
Backing up historical SaaS application data directly from an app into an organisation’s own secure cloud infrastructure, such as AWS or Microsoft Azure, makes it easier, and less costly, to maintain a digital chain of custody – or a trail of the different touchpoints of data. This not only increases the visibility and auditability of that data, but organisations can then set appropriate controls around who can access the data.
Likewise, having data from these apps located in one central, easily accessible location can decrease the number of copies floating around an organisation, reducing the surface area of exposure while also making it easier for organisations to securely pull data into business intelligence tools.
When healthcare providers have unfettered access to all their historical data, the possibilities for growth and insights are endless. For example, having ownership and ready access to authorised data can help organisations further implement and support outcome-based care. Insights enabled by this data will help inform diagnoses, prescriptions, treatment plans and more, which benefits not only the patient, but the healthcare ecosystem as a whole.
To keep optimising and improving care, healthcare systems must take advantage of new tools like SaaS applications. By backing up and owning their historical SaaS application data, they can do so while minimising the risk to patient privacy or compliance requirements. Having this ownership and access can propel healthcare organisations to be more data-driven – creating better outcomes for everyone.