Health Insurance Management
The world is constantly changing, and customers needs are growing more and more demanding each day. Insurers today need to respond quickly and adapt to a market with a growing range of services between insurance segments with different rules and prices, and with service providers that are located inside and outside of their network and spread countrywide or even worldwide.
Our integrated health insurance management module answers the various insurance management dilemmas and challenges faced today. build easily complex products with multiple benefit plans and multiple price lists to support business operations to effectively process deductibles, co-payments, coinsurance, and capitation among others. It also establishes premiums costs that can be collected from each insurance group to maximize financial forecasts.
As part of the back office administration platform, all relevant information is readily at the tip of your finger at all time Easily associate insurance products to companies or individuals, manage contracts, print insurance cards, manage all billing aspects such as proforma invoices, and manage payments with the integrated cashier module.
There’s no need to turn to an expansive external resource to come in and do it for you. Be self-reliant with the system’s user-friendly interface, and complete complex tasks such as configuring services and plans with easy-to-follow steps in just a few mouse clicks.
Every plan and configured service in this module will be checked thoroughly by the claims management module for claims adjudication. Services, business rules, and logic are pre-configured in the system to automatically adjudicate submitted claims.