Know the best health plans to work with

Know the best health plans to work with

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What are the best health plans to work?

When it comes to the best health insurance to work, often the health professional thinks be facing a catch. It is an adversarial relationship from the moment that the operators of health plans are placed between the patient and the doctor.

This intermediation causes various levels of conflict, starting with the interference of managed care plans in the autonomy of physicians. Research conducted in this decade point to many points of discomfort, fed by the pressure of the agreements by the reduction in the number of examinations of care for preexisting conditions, preoperative hospitalization, procedures and other therapeutic measures.

Another point of conflict are negative payment consultations and procedures already performed, a permanent headache, but nothing to compare with the greatest problems, which are the medical fees, stipulated far short of what can be achieved with private consultations .

The question, however, is that over 80% of medical consultations take place through agreements, which submits the most professional to submit to the conditions imposed by the health insurance companies to be able to maintain.

The other side

Despite the ongoing dissatisfaction of doctors to the covenants, the consumer does not seem to be afflicted directly or indirectly by the problems facing the class. If it is, you do not notice.

2015 survey commissioned by the ANS (National Health Agency), made with consumers to evaluate the performance of almost 1 200 operators in the country health plans, based on 28 indicators, found that 75.9% of branch companies obtained index between 0.6 and 1 (maximum score). It occurred, including an improvement in the assessment of the operators of health plans of 11.9% over the previous year.

Of course, it is mandatory to adopt the ranking of the ANS as a parameter for choosing the best options for health insurance providers to be accredited. It is guaranteed to be on the side of those with consumer approval.

The best health insurance companies

To see which are the best of health insurance companies, the physician should seek the site of ANS, which are registered the results of each company. The result is represented by IDSS – Performance Index of Supplementary Health.

Just by way of illustration, and getting in big companies considered it enjoys much prestige among customers Unimed. Among large companies, were ten local operators Unimed evaluated over the IDSS to 0.8 by consumers in the survey conducted in 2014.

Lead the preference Unimed BH, Vale do Taquari and Rio Pardo, Campo Grande, Curitiba, Maringa, Unimed Nordeste, Sao Jose do Rio Preto, Blumenau, Paraná and Juiz de Fora.

Appear with index between 0.6 and 0.79, considered good, exactly in that order, to South America, Hospital Marcio Cunha, Bradesco Saúde, Medservice, Porto Seguro Saúde, Petrobras, Unimed Campinas, St. Helena Health Unimed Divinópolis, San Francisco health Unimed Porto Alegre, Valley, national Central Unimed, Cassi, Unimed Vitória, Unimed João Pessoa, Promed, Unimed SC, Hapvida, Sobam Hospital Medical Center Ltda, Omint, Unimed Ribeirao Preto, Unimed Uberlândia, Notre Dame, APPAI, Unimed East Fluminense Box BRF – Brazil Foods S / A, Unimed Seguros Unimed Rio, Unimed Piracicaba, Unimed Christmas, Caixa Seguros Health Unimed Goiânia, Amil, Intermédica, Santamaria Health Foundation Health Itaú, Health Maritime, Unimed Santos, SEISA, Unimed Cuiabá, thus the SP Unimeds Federation, Vitallis, Unimed SJC, Unimed Grande Florianópolis, Charitable Association and Philanthropy of Saint Kitts, Senior Prevent, Cassens, Unimed Fortaleza, Clinical Center Gaucho All IANZ Health CAPESESP and Golden Cross.

It is a list of signs to start, as are the health insurance companies that concentrate the largest cooperative quota and at the same time, better evaluated.

An essential reference

All this information is on the ANS site, but not all. Both for the consumer as to the health professional, there is valuable information about each health plan company, every covenant, so that the doctor can mount its portfolio of agreements to be met.

The ANS site even offers graphics that inform the proportional relationship of released and suspended plans. Simply access the website with data as CNPJ, corporate name or fancy name for access.

The website shows individual data and compared the IDSS and other endpoints as claims ratio, which is divided into three indicators: overall rate of complaints, assistance completion percentage, which is the total number of resolved complaints and administrative proceedings opening index .

Gold parameter used is the program of “accreditation” health plan operators, which aims to certify the quality of service enterprises. The analysis is done by entities such as A4 Quality Services Audit and Certification Ltda, Brazilian Accreditation Consortium – CBA – Det Norske Veritas Foundation Carlos Alberto Vanzolini and ISOPOINT, all enabled by INMETRO.

Bradesco Saúde and São Francisco Xavier Foundation are certified best, followed by Unimed operators of Belo Horizonte, Vale do Taquari and Rio Pardo, Erechim, Paraná, Goiania, Northeast, Porto Alegre and Santa Barbara D’Oeste and Americana.

Regardless of your decision, it is important that the health professional sees his office as an enterprise that need strategic attention. You have to invest some of your time to plan actions for dissemination of practice and increase the quality of care.

Invest in a good management can impact on results rather than the office offers you every month. So it is important to start thinking about investing in technology to centralize all office processes – administrative, financial and strategic – in one place: a management software and marketing for offices.

In  iMedicina  we offer this possibility! Learn about our proposed visit to  our website  and better understand how to computerize your office and attract new patients!

Want to read more texts like this? So browse through our blog and check.

To delve further into the matter and find other tips for the financial management of his office, take a look at the items we prepared:

  • What you lose without an accurate control of the office’s finances?
  • Find out why your office needs URGENT a financial forecast
  • Complete Guide to improve the financial management of the office
  • Best practices in the financial management of the office

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