Significance of Outsourcing APS Summarization in Insurance claims

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Life insurance companies rely on underwriting process to reach a decision on the insurability of insurance claims. A healthy individual poses lesser risks to an insurance firm while an individual with more pre-existing health conditions raises the risk threshold. To analyze these risk factors, underwriters assist the insurance firms with APS medical summaries.

Before understanding the significance of outsourcing APS medical summarization, we should understand the importance of APS medical charts. Top medical record review service companies provide APS summary services too.

APS medical records and their significance

APS means Attending Physician Statement. It is actually the report prepared by the physician or facility that is giving the treatment and care to the injured or the individuals who are ill.

Attending physician charts (APS charts) will have many pages of significant as well as unwanted information. Digging for significant medical data through the voluminous pages of medical charts will be tedious.

The insurer may ask for an Attending Physician Statement when an individual apply for life, or disability insurance. The individual’s treating doctor gives the insurer any health-related information of the applicant that they request.

The underwriting process includes analyzing an APS medical records, which can help determine the applicant’s eligibility, rating, and premiums. This allows them to accurately evaluate your application while also managing their own risks.

Difficulties faced by underwriters while APS summarization

APS medical record summarization can assist the insurance underwriters immensely to take the underwriting decisions related to the claim applications. If they have to concentrate on the most significant base of their underwriting, it would be a herculean task.

The under writers have to dig through the APS records to know the applicant’s past diagnoses, family health history, physical as well as mental health issues, treatment details, and other symptoms, which were undiagnosed earlier. Analyzing these would consume a lot of time.

Normally they will look for the following health issues while summarizing the APS records.

· Anxiety or depression

· Bipolar disorder

· Cancer

· Diabetes

· Heart disease

· High blood pressure

· Sleep apnea

· Mental health conditions

To decide on the insurability of every claim, the underwriters have to unearth the significant information pertinent to the health, habits and the kind of work done by the applicant. When insurance companies have to scrutinize these records in order to do the insurance underwriting with the in-house team, it will eat up a significant amount of their money too.

Other main challenges faced by the underwriters in APS summarization are the baffling medical terminologies, which are unfamiliar to them, illegible and unintelligible handwriting and other inconsistencies in the medical records. This will delay their summarization process.

In case of people with complex illnesses such as cancer, APS becomes even more important. The APS assists the insurer in understanding the complexities of applicant’s problem and how he/she and the physician have dealt with it.

Another issue is the time delay from the underwriter due to his/her work schedule. Only a qualified doctor can prepare the APS records. Although paramedical exams can provide some information about complex illnesses, the technicians or nurses who perform them are not qualified to speak about the more complex health issues.

For the practicing physicians, APS record summarization will be an additional work. They will do that after their practice time. This will prolong the delay and the insurance underwriters will have to wait for weeks and months to get their work done. This time-lapse will further delay the insurance procedures.

What does the APS underwriting process involve?

Underwriting process involves

· Reviewing and evaluating applications

· Comprehending risk conditions

· Understanding risk classification

· Making a decision

Most insurance firms consider the below factors:

· The applicant's entire medical history

· The applicant's lifestyle, including any drug, alcohol, or substance use

· The current state of the applicant’s property

· Driving record with restrictions and revokes

· Applicant’s age and other risk factors, especially in the case of life insurance

Applicants with pre-existing health conditions like diabetes or high blood pressure will have higher premiums compared to others who are healthy. They may even have difficulty getting an insurance provider to cover them because of their high risk profile.

Advantages of Outsourcing APS summary

Outsourcing APS summaries helps to accelerate the underwriting process and save the time and money of the insurance firms. The APS summary services eliminate the troublesome work of underwriters by giving them with all relevant information in an organized format.

The medical records will be handled by expert nurses, data and quality analysts and experienced physicians and they present quality medical summaries with accuracy.

Highly trained medical summarizers in the outsourcing company gather the information in the records and organize them in an intelligible format.

Outsourcing the summaries will have the below-mentioned advantages.

· Highly experienced team

· Crispy and fact-oriented history

· Easy to peruse summaries

· Easy identification of medical records

· Neat presentation of information

· Tailored to suit the underwriter’s need

· HIPAA compliancy

The expertise of the medical summarization companies uphold and maintain the quality of the summary in its every aspect. A well-organized APS summary acts as an effective productivity tool for the insurance providers in arriving at the decision in a short period.

To conclude,

APS summarization is a vital part in the process of insurance underwriting and deciding the eligibility of every insurance claim. Insurance companies would need to spend more money on maintaining an in-house underwriting team to assist them. The expenses for the staff and space will be more when compared to outsourcing medical summarization.

Moreover, they may take more time to draft the APS medical summaries, as they would be bombarded with more insurance claims and forced to tackle everything together. Outsourcing APS summarization saves the time and cost of the insurance firms as well as creates a chance to make use of quality summaries for their work in a shorter period.

Insurance providers can even tailor their medical summaries with the outsourcing company and get exactly what they want. Fact and focus-oriented medical summaries save the time of scrutinizing the entire medical records. They can approve or disapprove more insurance claims by merely glancing through the medical summaries and complete the process in breeze.