Hubei Provincial People's Hospital Launches Province’s First One-Stop Commercial Insurance Settlement Platform
“Save time, worry less, and no need to pay out-of-pocket!”
On October 25, Mr. Wang completed the real-time settlement of his medical insurance, commercial insurance, and out-of-pocket expenses simultaneously during his discharge billing at Hubei Provincial People's Hospital.
“I never imagined that with just an online application, I could settle both my social medical insurance and commercial insurance claims at the same time and through the same window upon discharge,” said Mr. Wang. In the past, after receiving medical treatment, he had to personally visit the hospital to copy his medical records and then submit a claim to the insurance company. “The whole process used to take more than a week, which was not only time-consuming and laborious but also resulted in a lengthy period for advancing out-of-pocket payments.”
Mr. Wang is one of the beneficiaries of the newly launched “one-stop” settlement service platform for commercial health insurance at Hubei Provincial People’s Hospital. The establishment of this platform represents a new initiative by Hubei Provincial People’s Hospital to address the urgent, difficult, and pressing concerns of patients seeking medical care, thereby advancing its practical campaign of “Doing Practical Things for the People” in a more substantive and effective manner.
Hubei Provincial People’s Hospital Commercial Insurance “One-Stop” Settlement Platform is the first of its kind in the province and one of the few platforms nationwide that support real-time claims settlement for various insurance companies and policy types. After receiving medical care at the hospital, commercial insurance patients no longer need to copy documents, advance payments, or make multiple trips for reimbursement. By using the hospital’s commercial insurance claims mini-program, they can complete rapid claims processing in just a few simple steps, with funds credited within seconds. This reduces the previous 10–30 day claims processing time to instant reimbursement at the service window, thoroughly eliminating the difficulties of complex procedures and slow reimbursements.
“Launching the ‘one-stop’ settlement service platform for commercial health insurance will further enhance patients’ experience when seeking medical care at our hospital,” said Wang Gaohua, President of Hubei Provincial People’s Hospital, at the platform’s launch ceremony. Improving patients’ healthcare experience is one of the ten key initiatives prioritized by the Hubei Provincial Health Commission. “Commercial insurance users can submit claims through the platform and complete real-time settlement upon discharge, significantly reducing the time required for claim reimbursement, effectively alleviating the financial burden of medical treatment, and enhancing patients’ sense of gain, happiness, and security.”
Wang Gaohua stated that, following its launch, the platform will be open to all eligible commercial health insurance companies. By adhering to unified standards, processes, and services, it will gradually cover the major commercial health insurance operators in the market, providing “one-stop” settlement services for more patients with commercial insurance and continuously improving public satisfaction.
Wang Gaohua, President of Renmin Hospital of Hubei Province
It is understood that the platform has currently integrated with multiple insurance companies, including Ping An Life Insurance, Fude Sino Life Insurance, and Pacific Life Insurance. The initial phase of service rollout is available at the Shouyi Campus and Optics Valley Campus of the hospital. It is expected that more insurance providers will integrate with the platform in the future, enabling a greater number of commercial insurance patients to achieve “one-stop” settlement upon discharge.
Commercial health insurance is a crucial component of China’s multi-tiered medical security system for residents, with its share in total health expenditure rising year by year. According to data from the National Bureau of Statistics and the China Banking and Insurance Regulatory Commission (CBIRC), this proportion reached 5.8% in 2020. However, due to the wide variety of health insurance products and the large number of operating insurers, it is highly challenging to implement “one-stop” settlement integrated with basic medical insurance within hospitals. Consequently, most patients with commercial health insurance still need to file claims through traditional offline channels.
Implementing claims reimbursement for commercial health insurance within hospitals has been a key initiative that commercial health insurers have been striving to promote over the past decade. However, overall progress has been limited, primarily due to numerous unresolved challenges in establishing data connectivity and sharing between hospitals and insurance companies. As a result, many insurers have had to settle for alternative approaches, such as setting up claims service desks in hospitals or intervening early during patient admission to enable “proactive claims settlement,” thereby improving claims efficiency and service experience.
“Breaking down the data silos between healthcare institutions and insurance companies requires not only addressing compliance and security concerns but also considering efficiency and fairness,” said Fu Xinhua, CEO of Leyue Information Services (Shenzhen) Co., Ltd., the technical service provider for Hubei Provincial People’s Hospital’s “one-stop” commercial insurance settlement platform. He noted that it is highly challenging to implement direct data connections either by having a single hospital integrate with numerous insurance companies or by having an individual insurer establish separate links with many hospitals, due to policy, technical, and economic constraints. “Hubei Provincial People’s Hospital has effectively resolved this challenge through a platform-based model. By collaborating with an independent third party to build the platform, the hospital has established unified interfaces, standardized rules, and centralized management, thereby achieving efficient and equitable connectivity between the hospital and insurance companies.”
Following the launch of the “One-Stop” Commercial Insurance Settlement Platform at Hubei Provincial People’s Hospital, insurance companies can establish direct connectivity with the hospital, provided they comply with platform rules. Upon completion of medical services, insurers can perform real-time intelligent claims adjudication and transfer indemnity payments directly to the hospital. Patients are then required only to pay the remaining balance after deductions for both basic medical insurance and commercial insurance coverage.
Since the General Office of the State Council issued the “Opinions on Promoting the Development of ‘Internet + Healthcare’” in 2018, Renmin Hospital of Hubei Province has rapidly developed its “Internet + Healthcare” and smart healthcare service systems. This has enabled the digitalization of services ranging from online consultations and appointment scheduling to report retrieval and post-discharge follow-up, while also launching online service portals such as the “Wuda Cloud Doctor” APP. The recent launch of the “one-stop” commercial insurance settlement platform will further enrich Renmin Hospital of Hubei Province’s “Internet + Healthcare” service ecosystem.
By partnering with Leyue Health, a leading domestic enterprise in “one-stop” settlement for commercial health insurance, Hubei Provincial People’s Hospital not only provides more convenient settlement services to enhance patient satisfaction but also gains significant momentum for its own development.
In June this year, the General Office of the State Council issued the “Opinions on Promoting High-Quality Development of Public Hospitals,” explicitly stating the need to “accelerate the development of commercial health insurance and facilitate the clinical adoption of new medical technologies.” Experts believe that, against the backdrop of performance evaluations for tertiary public hospitals, commercial health insurance will serve as a key driver in facilitating hospitals’ transition toward high-quality development. Enhancing commercial insurance claims services will yield positive impacts in optimizing patient mix, improving revenue structure, elevating medical quality, and boosting patient satisfaction.
Renmin Hospital of Wuhan University, also known as Hubei General Hospital and the First Clinical College of Wuhan University, was founded in 1923 as the first government-run public hospital in Hubei Province. The hospital operates multiple campuses, including Shouyi, Optics Valley, and Hongshan, and features 127 clinical and medical technology departments covering all major specialties of modern clinical medicine, ranking among the top in China. In 2020, it ranked 11th nationwide in the Comprehensive Ranking of Hospital Influence in China, and in 2019, it ranked third among Chinese hospitals in scientific output according to the Chinese Academy of Medical Sciences’ STEM (Science and Technology Evaluation Metrics) rankings. Adhering to its mission of “Everything for the People’s Health,” the hospital is fully committed to honoring every trust placed in it by patients, striving to be a practitioner and leader in building a Healthy China, and serving as a creator and guardian of a better life for the people.
Leyue Information Services (Shenzhen) Co., Ltd. is a leading medical big data and insurtech company in China. The company is committed to enhancing the service quality of commercial health insurance administration, breaking down data barriers between healthcare and insurance sectors, and addressing key pain points for insured patients, such as difficulties in claims settlement, slow reimbursement, and cumbersome procedures. Leyue participated in the formulation of national standards for online settlement of commercial health insurance via electronic health cards issued by the National Health Commission. It has assisted the health commissions of more than ten provinces and municipalities, including Liaoning, Jilin, Shaanxi, Xiamen, and Shenzhen, in developing and operating commercial insurance service platforms, and has launched “one-stop” commercial insurance settlement services at nearly 200 public Grade-A tertiary hospitals. In partnership with Sinosoft, Leyue is driving the intelligent transformation and upgrading of the health insurance industry, and has established strategic collaborations with over 40 mainstream insurers, including China Life, Ping An Insurance, Taikang Insurance, New China Life Insurance, and China Pacific Insurance.