Recording medium having program for forming a healthcare network
Abstract:
A centralized network can be established by contracting medical facilities and insurance providers, in which the medical facilities agree to waive all or a portion of a deductible amount owed as part of their contractual obligation with the network. The insurance providers agree to provide a credit of the premium to be paid by beneficiaries that use a contracted medical facility to receive a service for which the deductible amount is waived. The cost savings and increased revenue recognized by both medical facilities and insurance providers can enable claims to be re-priced while reducing transactional costs for all parties. A computer program can more efficiently and accurately categorize healthcare claims into in-network claims and out-of-network claims, in order to analyze non-network hospitals that may be good candidates for joining the centralized network.
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