Health Insurance Companies, Essay Example

According to the perception of layman public, the activities of health insurance companies involve fraudulent obtaining money from public and establishing ingenious means of escaping payments of genuine medical bills of the clients. However, the truth is that members are accorded courteousness and compassionate treatment and given adequate protection from deceitful providers of health care. The functions of the company include administering, underwriting as well as selling of health benefit plans to employer groups in addition to employer associations, individuals, state governments, i.e. Medicaid, Federal government i.e. Medicare and the  Military.

Indispensable benefits in health insurance include the following: Ambulatory services to patient, patient hospitalization, laboratory services, pediatric services, such as oral and vision care, drugs prescription, emergency services, rehabilitative along with habilitative services,  chronic management of disease, preventive services,  maternity and care of the newborn,  substance disorder services, mental health and behavioral health treatment.

It is the responsibility of health insurance companies to perform data analysis and interpretation with application of intricate statistical models. Important data in this respect involve chronological data pertaining to the cost along with utilization of services in health care, data on  Local, regional as well as national trends, data on profit margin, chronological as well as projected operating expenses of the company and benefit design coupled with competitive environment.

The companies also design the premium rates that are commensurate with diverse products of health plan and also give the estimations of claims liability based on the product and the period of time. It is also the responsibility of the company to design, implement and manage health plan for the clients. The company also stores customers’ data that facilitate the determination of appropriate rates and terms of coverage of individual client.