Cayman First says systems explains insurance controversy Loop Cayman Islands

The content originally appeared on: News Americas Now

Black Immigrant Daily News

The content originally appeared on: Cayman Compass

In connection with the media controversy surrounding Cayman First, Cayman First has now issued a statement explaining that several issues experienced by customers and healthcare providers were linked to system upgrades and software issues.

Regarding this, Cayman First said:

Since the system upgrade in September 2022, we have worked diligently with our developers to make the urgent and necessary updates to our underwriting software. These updates have resolved the initial challenges experienced with the system upgrade, allowing us to automate our processes and significantly reduce the wait time for claims payments.

Cayman First also confirmed that healthcare providers have had access to Cayman First’s new online Health portal for client verification since December 2022, allowing providers to submit all claims online and quicker processing of claims and payments to providers.

“In addition, members will soon be able to access their invoices, claims, and benefits information via the portal,” Cayman First continued.

Cayman First further noted that the new portal and enhanced functionality of their underwriting software “will ensure that current and future claims are processed promptly, alleviate any pain points experienced by healthcare providers that had previously impacted a small number of providers’ acceptance of Cayman First member ID cards and allow our claims examiners to concentrate their efforts on working through the backlog of claims made in the interim period as quickly and diligently as possible.”

Lastly, Cayman First said it remains in regular communication and good standing with regulators, having met the conditions set by the Health Insurance Commission (HIC) and addressed their concerns around staffing and systems.

Regarding this, Cayman First confirmed:

On 15 January 2023, we provided the HIC with our quarterly financial reports for the year 2022 and a view of our outstanding claims. We will next be submitting an updated staffing plan, which includes a proposal to hire and train personnel dedicated to assisting those customers and claims that were impacted by the recent Health system upgrade and hiring a consultant to help us create efficient workflows.

Cayman First apologised for any inconveniences caused while they worked to rectify the issues.