Health insurance: how to start monetising the appointment process thanks to digital transformation?

Expensive operations and low satisfaction: why does traditional appointment scheduling fall short?

Without the support of modern technologies, traditional appointment scheduling requires extensive manual labour for managing schedules and paperwork. This manual administration necessitates additional staff, leading to high operational costs.

In addition to the administrative expenses, appointment scheduling also presents challenges that impact overall costs and patient service timelines:

Absence of Self-Scheduling Applications

Without integrated scheduling platforms, patients must contact the insurer or medical facility directly, which extends the time needed for scheduling, incurs additional costs and does not drive revenue.

Self-service solutions, like mobile applications or online platforms, can streamline this process and reduce phone calls and emails from customers.

Manual Coordination Among Patients, Insurers and Medical Facilities

In many cases, the patient must initially contact their insurer to receive details regarding the medical facility. Alternatively, they may need to contact the medical facility first, which is then obliged to verify the patient’s entitlement to services with the insurer.

This process requires numerous phone calls of varying lengths (with the client often having to go through triage before reaching a consultant on the medical business line) and interactions among the three parties involved. This approach not only prolongs the service time but also increases the risk of errors, which can lead to rescheduling appointments and, as a result, additional costs for the organisation.

Low Patient Satisfaction and “No-Show” Risk

A complex and time-consuming appointment registration process reduces patient satisfaction and increases the risk of missed appointments, commonly referred to as “no-shows”. Patient absences generate additional costs due to the need to reserve a doctor’s time, a technician or the equipment required for examinations, which will not be utilised effectively.

This issue is most common in the public sector. In private healthcare, patients expect a simplified booking process – if the system is time-consuming or difficult to use, there is a risk they will switch to competing facilities that offer greater convenience and easier access to doctors.

Limited Availability of Technological Support

Many health insurance systems still rely on outdated technologies, making integration with modern applications or appointment management systems more challenging and costly. Implementing modern technological solutions may require significant investment, but the lack of such systems increases overall administrative and operational costs.

Investing in technological modernisation is worth considering from a long-term perspective, accounting for the time needed to achieve a return on investment. Failing to take action in this area increases the risk of accumulating technological debt and may lead to the organisation failing to meet the growing expectations of patients, who, over time, become accustomed to increasingly intuitive solutions.

How to optimise the appointment scheduling process and start profiting from it?

Insurance providers can generate revenue from the appointment scheduling process by implementing new technologies that increase efficiency, reduce costs, and enhance the quality of patient service.

Automating Appointment Scheduling and Calendar Management

Replacing manual appointment scheduling with self-service systems, such as mobile apps or online platforms, allows patients to book and modify appointments independently (e.g., due to changes in personal plans). Additionally, patients can book appointments with multiple specialists without the need for a dedicated call centre consultant. Therefore, automation reduces the number of staff needed for customer service, lowering the costs the company incurs for employing a certain number of personnel.

Revenue from Telemedicine Services

Telemedicine solutions, such as online consultations, are less costly than traditional in-office visits, allowing insurers to reduce service costs. Insurers can introduce a “telemedicine-first” option, where remote visits serve as the initial stage for consultations and diagnostics, decreasing the need for in-person visits, which are more expensive from the insurer’s perspective.

This way, the patient receives appropriate support and only visits the doctor in person if, after the initial telemedicine assessment, it is deemed truly necessary. Meanwhile, the insurance company avoids incurring excess and inefficient costs.

Chatbots and AI Assistants

Chatbots and artificial intelligence solutions can automate the process of initial patient qualification and respond to queries related to appointment scheduling. AI not only replaces phone consultants but also enables 24/7 customer service. Additionally, chatbots and AI assistants help keep clients in the digital pathway for as long as possible, minimising the need to redirect them to manual (i.e., phone) support.

As a result, not only are labour costs reduced, but patient satisfaction also soars due to the swift response to their needs.

Appointment Reminders and No-Show Management

Automated SMS and email reminder systems sent before appointments help reduce the number of patient no-shows. This is an incredibly useful service, enabling patients to maintain control over their personal schedules in today’s fast-paced world.

According to Accenture research, as many as 70% of patients are more likely to choose a provider who offers appointment reminders via email or text messages. It’s no surprise, then, that such convenience has become a standard expectation among clients in the realm of technological enhancements.

Upselling and Cross-selling

Upselling and cross-selling are effective strategies that can help health insurers increase revenue within the appointment scheduling process by offering additional products and services tailored to patients’ needs. Modern technologies and automated systems enable the precise implementation of these techniques, enhancing both the insurer’s profitability and the quality of healthcare provided to patients.

Upselling

Example: Insurers can offer patients the option to extend their policy with additional benefits, such as a telemedicine package, access to specialised tests, or priority service at selected facilities. With integration into mobile apps or online platforms, patients are informed of available premium services while booking an appointment.

Benefits for the insurer: Upselling generates additional revenue by increasing the average transaction value per customer. It also boosts patient loyalty, as access to extra services provides added value that may not be available to competitors.

Benefits for patients: Patients gain the option to choose more comprehensive plans that better suit their health needs and gain access to additional services, which can enhance satisfaction and comfort with their insurance.

Cross-selling

Example: During the appointment booking process, patients can receive recommendations for additional preventive services, such as check-ups or wellness packages (e.g., dietary consultations and exercise programmes), which can be added to their insurance plan.

Benefits for the insurer: Cross-selling allows revenue growth by offering products that increase patient engagement and reduce health risks (e.g., preventive programmes). This approach also helps build long-term relationships with patients, strengthening their brand loyalty and reducing the risk of switching to a competitor.

Benefits for patients: Patients have the opportunity to expand their insurance plan with additional health benefits that can improve their overall health and help prevent illnesses. Preventive care is an increasingly common approach in society, and data-driven recommendations provide patients with services tailored to their individual needs.

Profits from Health Data and Analytics

Data collected during the appointment scheduling process and patient health monitoring is an asset that enables insurers to tailor their products and services precisely. Data analysis allows for patient segmentation and the creation of personalised insurance plans based on health history, lifestyle, and other risk factors. This ensures that patients receive insurance offers better suited to their needs, which can reduce long-term treatment costs and enhance their satisfaction and loyalty towards the insurer.

How to use new technologies in health insurance?

Altkom Software assists insurance companies in optimising processes and enhancing efficiency by providing both ready-made and custom insurance solutions that maximise automation and improve the customer experience.

Our solutions for maximum task automation enable the implementation of self-service systems, such as mobile apps and online portals, allowing patients to schedule appointments independently. This approach speeds up the process and makes it more accessible to customers while eliminating the need for manual handling of each reservation.

We leverage OCR and artificial intelligence (AI) technologies to streamline document processing. Our software automatically recognises and processes documents, reducing errors and speeding up patient registration.

The workflow engines we implement as the “heart” of the process manage workflow for appointment scheduling. We automate steps such as consent verification and appointment reminders, allowing full coordination of tasks across various systems, including CRM and EMR. This minimises the need for manual interventions, reduces administrative costs, and streamlines interdepartmental collaboration.

We support multichannel communication by integrating appointment scheduling through various channels, including the website, mobile app, call centre, and reception.

We develop flexible process pathways, tailoring insurance processes to client preferences and needs, and enabling the purchase of additional services during the visit.

Our systems also help minimise unnecessary appointments by integrating with advanced patient health monitoring tools, such as Health Checker and Health Monitoring.

Digitalisation of the health insurance market in the GCC region

In the global context of the health insurance sector, where digitalisation is a key component of modernisation, the Gulf Cooperation Council (GCC) countries are experiencing dynamic growth. In 2023, the value of the health insurance market in the GCC reached USD 17.4 billion, and it is projected to rise to USD 28.5 billion by 2032, with an anticipated annual growth rate of 5.6%.

These countries are actively investing in healthcare digitalisation, as evidenced by strategic initiatives such as Saudi Vision 2030, which emphasises technologies like AI, IoT, and telemedicine. Over the coming years, approximately 30% of healthcare infrastructure investments in the GCC are expected to be allocated specifically to digital solutions.

The GCC is laying the foundations for a modern healthcare system, where digital process integration is essential to service quality and accessibility. However, as in other regions, the lack of full technological integration can lead to costly limitations inpatient service. Without the implementation of modern technological solutions – both in the GCC and in other markets – processes like appointment scheduling remain inefficient, placing a burden on both staff and organisational budgets.

Summary

New technologies in health insurance bring not only cost savings but also increased customer satisfaction, ultimately translating into higher revenues for the company. Task automation, self-service tools, and telemedicine allow insurers to significantly reduce operational costs by eliminating the need for manual handling and reducing errors. With mobile apps and automated reminders, patients can easily schedule appointments and access additional services. 

Satisfied customers who value convenience and accessibility are more loyal and inclined to choose additional products. Investment in digital transformation, therefore, brings benefits on multiple levels – enhanced efficiency, cost reduction and long-term customer relationships, all of which contribute to improved profitability. 

Sources:

• McKinsey & Company, Digital is reshaping US health insurance—winners are moving fast
• HealthTech, Ease and Access: Why the Patient Scheduling Experience Needs an Upgrade
• Accenture, Today’s consumers reveal the future of healthcare
• Gartner, Healthcare Provider 2024 CIO Agenda Insights and Data
• IMARC Group, GCC Health Insurance Market Report by Type (Individual, Group), Service Provider (Public, Private), and Region 2024-2032
• Gulf News, Digital transformation in GCC’s health care industry