The government insurance company CINICO is introducing a new card for its 13,000 customers that will streamline payment for treatment at the Cayman Islands Hospital and Health Services Authority clinics.
The card will give customers access to a new instant insurance verification system, called CarePay, which will be rolled out from 1 October, said CINICO Chief Executive Officer Lonny Tibbetts.
Mr. Tibbetts said the new system will prevent outstanding debts from patients and misuse of the existing card system.
“Right now, we have a manual verification process where someone presents themselves to the HSA and the billing and authorisation department has to log on and verify coverage on the system.
“With the new system, the card has a magnetic strip that identifies you and your coverage… it can be immediately verified and will validate your eligibility for specific coverage and benefits – all in real time,” he said.
The new CarePay card will replace the current CINICO card, which healthcare providers will stop accepting after 30 September.
Fraud prevention
To prevent fraudulent use of the card, patients who show up at the outpatient clinic at the hospital, for example, will present their new CarePay card and will be asked for identification, to ensure that the person holding the CINICO card is the person whom it covers.
Mr. Tibbetts said there had been instances of people giving their CINICO cards to others who used the cards to obtain free treatment.
The new system will also prevent the use of CINICO cards by former government employees or others who are no longer covered by CINICO, he explained.
“We’ve seen cases where civil servants who have stopped working for government since December, coming to the HSA in January or February and producing their CINICO card and receiving treatment. By the time the billing department goes to verify the coverage, that person is gone. With the new card, the verification is instantaneous,” he said.
CINICO insures all civil servants, pensioners, seafarers and indigents.
“None of the existing benefits are changing with the new card,” assured Mr. Tibbetts.
The CarePay card can be used globally for any medical or dental service with a chief medical officer or chief dental officer pre-authorised referral.
Registration
The card will be issued to all members of CINICO who complete a short and simple registration form, which CINICO has begun to distribute.
Forms will be delivered to government employees by their relevant department heads; statutory authorities employees will receive the form from their head offices; and seafarers and veterans will receive theirs from their association offices.
Civil Servant Pensioners will receive their forms through the mail and the Department of Children and Family Services will give forms to their clients who are covered by CINICO.
Standard Health Insurance Contract, or SHIC, plan holders will receive their forms in the mail or they can collect them from the CINICO office on Grand Cayman or at the Government Administration Building on Cayman Brac.
“It is extremely important that CINICO members complete and return the forms to ensure they get their new CarePay card before the end of September,” Mr. Tibbetts.
The information contained on those completed registration forms will have the added benefit of enabling CINICO to update its database of its customers, he said.
Benefits to HSA
Lizzette Yearwood, chief executive officer of the Health Services Authority, explained that CarePay’s validation of coverage and guarantee payment for medical services at the hospital and clinics would enable the Authority to increase revenue and reduce expenses.
About 90 per cent of the Authority’s budget comes from CINICO and private insurance companies that require claims processing. Each year, the Health Services Authority processes about 400,000 claims.
“The CarePay card will make the entire bill-paying process much more user-friendly. Patients will find that the system is very simple to use and will help to quickly clarify insurance coverage.
“We hope that this will be a model that other insurance companies will be able to adopt in the future so that all insured patients can benefit from this much simpler process,” said Ms Yearwood.
According to the tender invitation document for the new system which was released last year, between 26 per cent and 34 per cent of the Health Service Authority’s current healthcare administrative overheads are spent on claims processing, largely due to incorrect patient identification and eligibility checking that leads to the “cumbersome and costly process of managing bad debts and the rework associated with denied claims”.
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