With approximately 14,000 employees, BARMER caters to the needs of nearly nine million insured people. For medical aids alone, the company manages a budget of over one billion euros every year. With its online aid platform and partners T-Systems and HMM Deutschland, BARMER is perfectly equipped from an organizational and technical perspective to meet increasing requirements heading into the future.
In Germany, as per prevailing laws, medical aids are provided to the insured in case of illness or need for care. These include spectacles, insoles and orthoses as well as measuring devices, wheelchairs and beds. According to the list of medical aids provided by the statutory health insurance funds in Germany – these amount to 30,000.
In rare cases, patients buy these aids themselves in medical supply stores, but usually they receive them via a doctor’s prescription. All these prescriptions can be redeemed at any of the approximately 3,000 medical supply stores in Germany.
The medical supply stores submit the prescription, including the cost estimate, to the health insurance fund. The health insurance company checks the need and then pays the costs. Several parties are involved when it comes to ensuring that, for example, a patient who had recently undergone an operation receives crutches promptly so that they can be mobile in their private environment.
BARMER was following a manual, time-consuming process before it embarked on a partnership with T-Systems for digitalization.
Every month, BARMER employees from nearly 400 offices nationwide manually checked thousands of prescriptions for medical aids. This is because the dispensing of medical aids must be approved by the health insurance company in accordance with the Medical Aids Directive. Employees also had to verify whether the prescribed aid fits the diagnosis. After the verification, the clerks initiated the process so that the patients receive their aid - either by collecting it from the medical supply store or as a delivery.
Previously, the patients had to wait for a few days to receive their medical aid after the examination and the transmissions were completed. They had no visibility into how their requests were actually processed. The only option for them was to call the BARMER customer care team to receive the current status – resulting in more time required to manage customer calls (see graphic – Part 1).
“Every one of us who orders goods privately on the Internet today expects them to be delivered tomorrow,” explains Jürgen Rothmaier, Vice Chairman of the Board of Management of BARMER. “Our customers also transfer this expectation to the services of a health insurance company. With this in mind, our Central Healthcare Platform (ZHP) contributes to leaner and more efficient processes, ultimately improving the quality of service for our customers.”
It was only logical that BARMER wanted to use a digital solution to speed up and optimize the provisioning process, while saving costs and increasing transparency for customers.
With the Central Healthcare Platform (ZHP) from T-Systems’ partner HMM Deutschland GmbH, BARMER found the right software support to digitize the process for the provision of medical aids. The software is provided from a secure German data center. BARMER's administrators and the employees of the affiliated medical supply stores can access the software from their end devices.
As BARMER's IT partner, T-Systems ensures that the software works perfectly with the health insurance company’s other systems, even after customization. Just one example is the core system oscare®, which the health insurer today uses to run its entire private customer management.
The previous process of postal submission of the prescription and the cost estimate by the medical supply store required scanning and manual correction of the data before it could be processed further. This process today is mapped completely digitally by ZHP.
The software “knows” which aids are available where, coordinates the sourcing on this basis and involves the relevant medical supply stores. The software also relieves BARMER’s employees of the burden of manual checking (see graphic – Part 2).
ZHP is gradually being expanded to include information channels that give the customer a better overview of the care process and its concrete status.
Since the entire process takes place within the software, a manual transfer between different channels is no longer necessary. This increases the data quality and reduces the likelihood of errors.
Above all, however, ZHP speeds up deployment as most of the manual steps have been eliminated. The digitized process has reduced the workload for BARMER employees and they can spare more time for other customer-oriented activities.