Empowering mobile healthcare providers via a patient benefits authorization service

Moving rapidly between patient examining rooms, physicians have to examine, diagnose and decide on a course of treatment appropriate for each patient. However, if the patient's health plan administrators subsequently deny coverage, the prescribed treatments would then have to be changed. There are a wide range of health insurance plans and varying cost curtailment procedures. Physicians are therefore ill-equipped to determine a course of treatment that addresses the patient's needs and complies with the payer's regulations. Benefits authorization applications on handheld devices using wireless communications can help mobile healthcare providers quickly determine patient medical benefit eligibility. Such facilities could improve the quality of care and physician patient communications, prevent denial of services by health plan administrators and consequential expenses to the patient. The authors originally developed a prototype desktop application as part of a secure telemedicine research project. They identify enhancements to this work to address interoperability issues and support the needs of mobile healthcare providers.