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商业保险如何助力诊所发展?

2018-11-27 柒小略 “看医界”微信号

医保支付的局限性是很多社会办医疗机构面临的一个重要问题。

医保支付的局限性是很多社会办医疗机构面临的一个重要问题。

据统计,目前我国社会办医机构已超过44.6万家,占医疗机构总数的45%;全国社会办医院已经达到1.8万家,占医院总数的60%,并且还在以平均每年2000家的数量增加。对非公医疗机构来说,提供较好医疗服务的同时往往意味着营运成本的提升,但医保支付缺失或仅覆盖基础费用导致病人的就诊消费意愿下降,因此非公医疗机构与商业健康险结合成为必然的发展趋势。

但是,医疗机构在选择保险公司时往往出现各种各样的问题,这些问题如何解决呢?

医疗机构引入商保的困境

商保行业专业第三方服务公司风石健康创始人陈宗认为,医疗机构在与保险公司沟通合作中,常常面临以下困境:

选择困难。市面上商业保险公司那么多,找谁去合作,怎么合作使很多医疗机构出现迈开第一步的困难。

推进缓慢。有些医疗机构与保险公司沟通良久,貌似合作产品可能很大,但慢慢地就没了下文。

客户量少。有些医疗机构好不容易和某家保险公司签订了合作协议,可是良久却没有该保险公司客户来。

运营支持。为了服务保险公司客户,医院需要高价组建保险营运团队。

建立商保市场部和运营中心

医院在与保险公司签约之前,要有负责商保的市场部人员,负责准备签约保险资料、保险公司沟通;而在保险市场推广过程中,要和保险公司定期联络更新,提供健康讲座,义诊,优惠券,与保险公司洽谈产品合作,并通过医疗增值服务,留住高价值保险客户。

引入商业保险之后,医院还需要组建团队进行运营,并渗透到患者“诊前--诊中--诊后“整个过程:首先要建立标准的业务流程,确保每一笔理赔从发生到结案系统完整记录和追踪,然后要建立商保管理系统,补充医院HIS系统保险模块,最后还要建立多语言呼叫中心,覆盖医疗机构服务时间。

如何与保险公司合作

中国市场变化日新月异,医疗机构必须要完整了解目前保险市场情况:包括各家保险公司目前情况及战略发展、保险公司与医疗机构的合作态度和原则、目前保险产品的开发及合作热点、未来需要的服务类型等。

保险公司和医疗机构的合作模式主要由以下几种服务组成:1.基础服务:医疗机构作为保险公司客户的医疗合作方,为客户提供保险合同涵盖的医疗服务;2.增值服务:医疗机构为保险公司客户提供健康讲座、义诊、就诊优惠券等服务;3.附加服务:医疗机构协助保险公司的医疗团队,提供专家建议、二次诊疗、绿色通道等;4.产品合作:通过和标准的第三方公司合作,由第三方公司串联和标准化服务体系,从而对接保险公司,这也是一个比较容易的参与方式。

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    2018-11-29 ycmayy
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    2018-11-29 feifers
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    2018-11-27 1dd8a7c5m95(暂无匿称)

    好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。

    0

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