Goran Safar |

More efficient processes through partnership-based development


Insurance companies are constantly faced with new regulatory requirements, which often lead to high implementation costs and will continue to do so in the future.

In the case of health insurers, for example, one doesn't have to look that far back into the past to the 2009 Citizens Relief Act (BEG) or the introduction of unisex rates in 2012. Some examples of major upheavals can also be found in the more recent past, such as

  • the modernization of the German Insurance Tax Law (Art. 4 VersStG) in 2021,
  • the provision of a health insurance number (KVNR) as part of the Implant Register Act (IRegG) which will take effect in 2024 and, last but not least,
  • the replacement of the previous paper procedure for the certification of tax-exempt contributions eligible for employer subsidies (employer's certificate in accordance with Art. 3 of the German Income Tax Act (EstG), Art. 257, Volume V of the German Social Security (SGB V) and Art. 61 SGB XI) as well as the pension lump sum for calculating income tax (tax certificate in accordance with Art. 10 EStG) which will take effect in November 2023.

Most of these legal innovations are intended to promote digitization, to simplify and improve existing processes or to close existing gaps and thus increase safety for everyone involved, just as, for example, the implant register and the associated health insurance number contribute to improving the safety and quality of implants and thus ultimately contribute to better medical care and better health for all insured persons.

However, the question arises whether the implementation of these innovations one of the core competences of the companies in a given industry, so that it is profitable for these companies to make such an investment? This will be explained in more detail below, using the example of health insurance.

What are the challenges to be mastered?

It can take several months to implement the regulatory requirements, such as the processes for providing, managing or clearing health insurance numbers or expanding the requirements for employer and tax certification to take into account the actual contributions made.

This effort must be made by each individual health insurer for the initial design, implementation, testing and the subsequent maintenance of these processes.

The core competence and aspiration of health insurers is to develop and manage efficient products that meet the needs of their customers, and to continue to be a customer-focused healthcare provider for their policyholders over the long term.

Currently, many health insurers are in various phases of digitizing their processes or transforming themselves from simple reimbursement providers into health service providers. Just like other industries, health insurers have to contend with the challenges posed by the shortage of skilled workers and must try to make efficient use of their existing resources.

Against this backdrop, it is clear that, while these regulatory requirements are reasonable and necessary, they place an additional strain on the available IT and specialist resources of insurance companies, thereby indirectly impacting the accomplishment of the companies' business goals.

Thus, although it is essential for each individual health insurer to implement the regulatory requirements, it is not profitable if everyone has to do it themselves.

How can standard software help?

Standard software on its own is not the solution to every problem. For example, if the software provider does not have access to the information and test environments of the German Association of Private Health Insurance, it will not be able to provide and test standard software solutions that meet the requirements.

Generalized solutions can only be developed and implemented or updated in line with requirements if the software provider and those who use the software work together as partners.

A good example of this kind of partnership is our approach to the subject of implant registers and the provision and administration of health insurance numbers. We worked out the requirements with our partners in the health insurance industry early on, which only tied up a minimum of resources at these insurance companies.

Together, we focused on the most automated processes possible and on simple and lean integration. Ultimately, the design, implementation and integration of the software should be efficient for everyone involved, and the software should make the daily work of employees easier wherever possible.

Based on this approach, we have already been able to deliver a software solution that only ties up the resources required for integration at the insurance companies during the implementation of the solution.

What are the resulting increases in efficiency?

In areas where there is little room for customization due to regulation or where this need does not exist, the use of in-house specialists is not an efficient or appropriate solution. The work of these specialists can be applied more profitably in the design and implementation of individual company goals or in the transformation of the company's own digital systems and processes.

Accordingly, the regulatory system should be mapped by standard software that can be quickly integrated into the company's processes. In turn, this is only possible through design and development in partnership with the software provider, who then implements and maintains the software. Each company can then focus on its own core competencies and thus all companies increase their efficiency.

Would you like to learn more about increasing your efficiency through standard software? Please feel free to contact our expert Karsten Schmitt, Head of Business Development.

Do you have any questions or comments? Then please leave us a comment.

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