Managing the Insurer Interface - An Operations Management Perspective on Pre-Authorisation and Claims Workflow in Sri Lankan Private Hospitals

This paper is written for hospital managers. It sets aside the regulatory question of how insurers should be supervised, which is a separate issue, and asks what a hospital can do with its own processes to make the insurer interface faster, cheaper and less painful for patients. The argument is that this interface is an operational process like any other and should be designed and managed as one.

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Publication Details

Journal
Zenodo (CERN European Organization for Nuclear Research)
Published
2026-11-02
DOI
https://doi.org/10.5281/zenodo.23887381
Primary Topic
Healthcare Quality and Management
Type
preprint
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preprint

Managing the Insurer Interface - An Operations Management Perspective on Pre-Authorisation and Claims Workflow in Sri Lankan Private Hospitals

Rathnayake Manula
1 links
Zenodo (CERN European Organization for Nuclear Research)
Healthcare Quality and Management
preprint

Managing the Insurer Interface - An Operations Management Perspective on Pre-Authorisation and Claims Workflow in Sri Lankan Private Hospitals

Rathnayake Manula
preprint en

Abstract

This paper is written for hospital managers. It sets aside the regulatory question of how insurers should be supervised, which is a separate issue, and asks what a hospital can do with its own processes to make the insurer interface faster, cheaper and less painful for patients. The argument is that this interface is an operational process like any other and should be designed and managed as one.

Zenodo (CERN European Organization for Nuclear Research)
International Committee of the Red Cross (CH)
Healthcare Quality and Management
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