How to Choose Between Building or Buying an Insurance Card Capture & Verification System

Efficient insurance verification is essential in the constantly changing healthcare market. There are two main choices: working with a specialized provider or creating your own system. Thought should be given to the unique benefits and difficulties that each route presents.

The Case for Building

You can take full control and customize the system when you build an AI-powered health insurance card capture and verification automation system. It is complicated and comes at a significant expense though. Starting at $1,000,000 to $5,000,000, the cost of design, development, and implementation can be tripled over time by continuing maintenance.

AI models, OCR, compliance, and ever-changing payer landscapes require a highly qualified workforce to manage. The reward of proprietary software customized to meet certain requirements is undeniable, but the risks are also great since mistakes could damage one’s reputation.

The Case for Buying

Choosing to purchase an insurance card capture system results in substantial time and cost savings. Expenses are controlled and predictable using transaction fees and API subscriptions. Usually, the only technical prerequisite is integration skills. The main risk is selecting the appropriate vendor, but there are significant benefits as well. The solution may be put into practice quickly and is maintained by a specialized staff. By eliminating repetitive work and support expenses, this strategy can save up to $14,560 per employee year.

Combination of Worlds

By combining the simplicity of a ready-made system with the personalization of a built system, there is a hybrid solution. After being trained on a large amount of payer and plan data, their AI model provides quick and precise verifications.

Orbit validates, verifies, and maps data to EMR/RCM systems in real-time, with a payer identification rate of 98.5%. Achieving 40% to 60% cost reductions through automation, it supports a variety of input forms, including insurance cards, online wallets, and referral letters.

Deciding between building and buying depends on your organization’s resources and needs. Some companies offer a stable and effective system that combines the best aspects of both approaches.