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How to Build a Health and Medical Insurance App

Paul Kovalenko Paul Kovalenko | October 11, 2021 | 12 min

Digital transformation has tackled every corner of the healthcare industry, including medical records, pharmacy and hospital management, telehealth, billing, equipment, etc. Consequently, the market of health technology is about to reach $280 billion, making it a thriving and attractive niche.

This transformation has been long-awaited by both patients and doctors. It makes their lives easier, accelerates all data management processes, and helps make the industry as transparent as possible.

Insurance companies, as one of the key players in the market, felt the need to change as well and started to launch apps that connect patients, doctors, and insurance providers. Oscar, a US-based company that provides health insurance policies, was the first to introduce a health insurance app that now has over 520,000 users. Other big companies such as Aetna, UnitedHealth, Humana, Cigna, and Anthem have apps now as well and many active users have the ability to manage their treatment coverage and search for the best healthcare providers.

Here are some statistics illustrating the steady growth of the US health insurance market:

It is obvious that a health insurance app is necessary in small private health insurance companies as well. Patients want to get recommendations from their insurance provider and connect with both medical workers and insurance companies within one app.

Do you want to create a health insurance app that will boost customer satisfaction levels? Do you want to gain a competitive edge and establish your reputation as a modern company that cares about its clients? Then you have landed on the right page! Discover health insurance mobile app models and types to choose what will work best for your company and find out how to build a health insurance app.

Types of Health Insurance Applications

Firstly, so you can see the big picture of the digital health insurance market, let’s unveil the key players. Health insurance apps connect three main points: healthcare providers, insurance companies, and patients. Every user type has completely different needs and uses the application.

As a comprehensive solution, you can also develop a single app that is the most relevant for your company, depending on who your main stakeholder is.

Let’s take a look at how these app types differ and what functionality they offer.

Health Insurance App for Patients

This type of app is the most widely used one and has the highest number of users. The process of patient health insurance app development is quite complex, as such software requires a more sophisticated functionality due to confusing insurance policies.

Developing health insurance software for patients means creating the following features:

EHR/EMR integrationAn EHR solution contains all the records so that users can view their medical history, review their medication recommendations, check-up results, screening results, etc. The app’s integration with EHR/EMR systems helps patients to not only understand their health better but also see exactly what they are paying for.
Recommendations about healthcare providersThis feature allows users to choose different healthcare providers based on their needs such as hospital proximity, doctor’s expertise, ratings, available prices, insurance coverage, etc.
Insurance claims dataWith an all-in-one dashboard encompassing insurance claims, users can enjoy full transparency and scam prevention.
Medication finderA useful feature for patients to compare the prices, choose the best one, and find pharmacies nearby.
RemindersSend notifications about upcoming appointments, insurance payments, or plan renewals.by.
Plan recommendations and updatesProvide users with recommendations about their insurance plan. Based on data like patient’s income and health conditions, create personal instructions that fit their needs.
In-app paymentsEnable secure in-app payments for users to make the transaction as easy as possible. Make sure to use the best HIPAA-compliant credit card processing practices to ensure maximum protection of user’s data.

Health Insurance App for Healthcare Providers

This type of app is not very popular since healthcare providers deal with too many insurance companies and cannot manage the applications from all of them. However, if you’re still wondering how to develop an insurance mobile app for healthcare providers, you need to ensure that your solution allows users to:

  • Check a patient’s eligibility
  • Verify patients’ documentation and insurance ID cards
  • Send claims without the need to email or call the insurance company

In case you need help defining the full list of features that should be incorporated into your app for healthcare providers, feel free to contact Langate. We will analyze your situation and needs and offer the best-fitting solution.

Health Insurance App for Insurance Companies

Insurance companies, in turn, need the app for automating their business processes, avoiding paperwork and mistakes arising from it. With these apps users can:

  • Get reminders about claims that need to be covered
  • Receive updates about a patient’s status in real time
  • Access the analytics on business performance

It also helps insurance providers manage their relationships with customers, boost their communication strategies based on analytics and employees’ performance, attract new customers as well as keep the old ones.

Health and Medical Insurance App Business Models

After coming up with the idea for your health insurance app, it’s important to choose the monetization model based on users’ expectations, market trends, and your business needs.

A health and medical insurance app is an extra revenue source for health insurance service providers in the United States. ZhongAn, for example, was able to generate a $16.88 billion profit in 2019 by promoting different companies on their app!

You can generate revenue by using 4 major business models for health and medical insurance applications:

Freemium

Freemium means that a user can use the app for free, but they pay extra if they want to upgrade to a premium plan without ads or with additional functionality. Apps with the freemium model also use advertisers and physicians that want to appear on the app as an additional revenue source. Freemium is more popular for young users.

Business benefit of this model: Freemium model helps to easily aggregate a large user base which later can be monetized through various techniques.

Licensing

Licensing means that a user must buy the app to use it. The additional sources of revenue are usually insurance plan promotion and selling medications through the app. The licensing model is more popular in the health tech market and is fitting for platforms that already have a wide range of users.

Business benefit of this model: With licensing you have the ability to predict the revenue which will be generated in the next periods and use this to improve cash flow.

Advertising

An app receives revenue from advertisers as a publisher. However, it is especially important in health apps to avoid disruptive ads that slow down the usage of the app significantly. Health apps are often used in case of an emergency, and it is important to give the user information, without them having to close numerous pop-ups. It is also essential to show relevant and inoffensive ads.

Business benefit of this model: By selecting the advertisers whose offers satisfy the needs of your users and working on a CPA basis with them, you can successfully monetize a large part of your traffic. However, you won’t be able to fully monetize all of your inventory with this approach, so it’s better to combine it with other revenue sources.

Promotion

Since numerous health insurance apps help patients find doctors and pharmacies, they can charge the physicians and stores for the promotion of their services. For example, they can be featured at the top of the list of search results, offer discounts and exclusive deals to the app’s users, etc.

Business benefit of this model: By establishing long-term strategic partnerships with clinics, pharmacies, and doctors, you can generate stable and predictable income flows.

What are the Benefits of the Health Insurance App?

Building a health insurance app requires an investment of time and money as well as constant improvements. However, it can turn out to be a profitable business model. To gain a profound understanding of how to create a health insurance startup it is important to discover what makes such solutions so valuable for the differing groups of users.

Benefits for the Patients

Easier Navigation of Practices and DoctorsA user can get lost in all the Google results while analyzing physician’s proximity, expertise, reviews, acceptance of insurance policies, etc., so it takes time for patients to find the right professionals. Health insurance apps have a good search system, with numerous filters, insurance eligibility information, and short descriptions for every doctor.
Reduced PaperworkPatients no longer need to print out claims records to compare them to health records. All the information is stored neatly in the app and users can access all of it with a few taps and swipes.
Cost ReductionUsers can find the most fitting health insurance plans, physicians with the best charge rates, and pharmacies with the lowest prices. If they did not have all the information packed in one app, they would have to spend hours on finding opportunities for cost reduction one by one. With a health insurance app, finance control becomes so easy that it will be a waste to not use the tool.
Informed Decisions and ControlHealth insurance apps provide information about a patient’s health, the quality of physician’s service, different insurance plans and who they are designed for, etc. With such a full data set, patients feel like they have more control over their health, data, and decisions.

Benefits for Insurance Providers

Process AutomationIt is easier to work with modern databases that update information in real time, create automatic reports, and send notifications. Insurance companies are therefore highly unlikely to make mistakes, lose documents and claims, or forget to process them.
Focus On Strategic Tasks:When all the routine processes are automated by software, a business can focus on more important tasks: growing the customer base, retention, employee management, productivity increase, etc.
Higher ROICustomer experience is essential for high satisfaction rates and revenue flow. A health insurance app helps employees to manage customer inquiries more effectively, track all the pending messages, and use chatbots for answering simple questions.

Main Steps on How to Develop Health Insurance Software

There are 4 stages of developing health and life insurance apps: planning, healthcare insurance app development stage, compliance checks, and testing. Such steps allow you to create an application that will remain relevant and be as successful as possible during the first launch.

Stage 1: Planning

The planning stage involves thorough research and the planning itself. It is essential to research the market of health insurance apps: their core features, trends, positive and negative reviews that will help to define the user’s needs. Such an analysis would help you define your business model, understand which functions are necessary, and how to provide the best user experience. If you discuss as many details about the future app as possible, you are less likely to run into project issues, last-minute changes, and the unexpected budget increases that they bring.

After you have decided upon the functionality and design, you can define a tech stack, build a team, create tasks and assign those responsible for them, plan the budget, and the timeline. Such a roadmap will assure that everyone knows what to do and when, so the process of developing health and medical insurance app goes smoothly and on schedule.

Stage 2: Development compile

Choose the IT cooperation model based on the tech expertise available in your team, your budget, timeframes, and business goals. You can choose between:

  • Hiring an in-house development team
  • Using the services of an outstaffing agency to scale your team
  • Outsourcing certain tasks to the dedicated development team
  • Cooperating with the tech partner

During the development stage, it’s important to ensure that all team members including the developers, designers, QA engineers, the business analysis team, and technical writers follow the defined roadmap. It is better to hire a project manager who can control the situation and communicate with the upper management.

Stage 3: Testing

Testing is an essential part of the development process. By constantly checking the newly released versions of the product in various use cases, you can quickly detect bugs and flaws in the user experience. Apply the necessary changes along the way to receive a final product of the highest possible quality.

You also should remember that every software product needs constant updates and maintenance to keep up with the rapidly changing needs of the market.

Stage 4: Compliance Checks

One of the major challenges in healthcare technology development is compliance. The industry faces many legal regulations about data protection, the breach of which will cost thousands of dollars. There are different requirements in every country:

The US, The Health Insurance Portability and Accountability Act (HIPAA), and the Health Information Technology for Economic and Clinical Health Act (HITECH)

HIPAA and HITECH require the security of protected health information (PHI) on both digital and physical levels. It’s unusual that business associates are considered responsible for the breaches as well and will have to face the penalties along with the healthcare provider. The fines go up to $50,000 for a single breach and can become up to $1.5 million per year.

EU, the General Data Protection Regulation (GDPR)

GDPR requires the protection of all personal data, including medical information. The most important things in the regulation are explicit consent and data transfer to other countries: even organizations outside of the EU that have breached the data of an EU citizen will have to face the penalty. The fines can go up to €20 million.

Canada, Personal Information Protection and Electronic Documents Act (PIPEDA)

PIPEDA is quite similar to HIPAA, but it covers all personal data, not just medical information. The fines are higher as well: they can go up to $100,000 CAD.

Reasons to Choose Langate for Building Your Medical Insurance App

Langate offers vertical-specific expertise in health tech development. With more than 15 years of experience in the industry, we know how to develop a health insurance app that will fit the unique needs of patients, medical workers, and healthcare organizations.

If you are looking for a health insurance app development company that would provide business advisory services, offer consultations about compliance and quickly hop on the project, contact us!

Conclusion

Implementation of an insurance app is an inevitable step for healthcare or insurance companies regardless of their size. With this solution and clear understanding of how to build a medical insurance app, both big corporations and private companies can remain relevant in this ever-changing world.

Even though the development of the health insurance mobile app will take time and money, the benefits for both patients and insurance providers are incredible: reduction in cost, paperwork, and the number of routine tasks, as well as an increase in customer trust and improvements in the company’s productivity- they can focus on growing rather than surviving.

Hopefully, this article has helped you to gain a better understanding of how to develop a medical insurance app. If you want to receive all the benefits while working with experts in health tech development, then do not hesitate to reach out to Langate! We would use our extensive expertise in healthcare development and compliance to ensure a fast time to market and a smooth development process.

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