Among the business processes that drive the insurance operations, nothing is more complex to manage compared to claims processing, especially in the healthcare sector. This process is where the insurance company delivers on its commitment! How fast, accurate, secure and convenient, the company settles claim transactions distinguishes its brand in the industry!
Our Solution & Service
Healthcare Industry Ecosystem
An integrated Claims Management SaaS on the cloud that aims to link all partners of the Healthcare Ecosystem for facilitating medical claims application, assessment, and administration on Health Maintenance Organizations (HMO) and Health Insurance Companies.
Our Software Info
Auroa Web and Mobile App
Front-end: Web and Mobile Enabled
- Automated Web Claims Application
- Mobile App for Members Benefits Info and Data
Core insurance Function: Automated end-to-end Claims Processing – Authenticate-to-Pay :
- Supports Fee-for-Service or Case Rate Plan Model;
- Automated medical claims adjudication (real-time);
- Electronic transmittal of Claims Summary per agreed billing cycle;
- ERP/Computerized Accounting System integration
- Generation of Management Reports
Configurable definition of Business Rules without IT intervention
Overall view of all Claims-related transactions across all accredited Healthcare Partners
Validation of allowable medical procedures (CPT) made against ailments (ICD-10) on claims application
HIPAA Compliant Hosted Cloud Platform
- Modules managed and controlled by Customer authorized users.
Our company started operations in December 2020. It was a year of significant challenges and the start of an unprecedented shift to digital and mobile technology by businesses energized by a global crisis.
We come from diverse industry backgrounds and experiences that span for more than 70 years collectively – from Telecom, Energy, Healthcare, Health Insurance, Retail & Distribution, Airline, Transport, Engineering, and Information and Communication Technology. Inspired by our extensive development and implementation of systems on Fintech, we saw the opportunity to transform the health insurance claims process, which has relied on the exchange of documents being prepared by the relevant parties, to a completely digital workflow. Such longstanding practice is not only prone to recurring errors and rejections, long turnaround time but also a very costly process to sustain by health insurance payers.
We developed Aurora MedClaims; a software system on the “cloud” for the management of health insurance claims from medical partners. It is intended for use by health insurance payers, medical providers, pharmacies, and policyholders. The digital solution is a transformative divergence from the traditional way of processing insurance claims that that significantly enhances efficiency while cutting down administrative costs!
The software application is a result of a careful study of the challenges and issues affecting the health insurance claims process here in our country. We employed the Lean method of BPM analysis in the design of the system to support the authenticate-to-pay end-to-end process. Our research and development included fieldwork surveys, interviews, and actual interactions with medical providers, insurance companies, and policyholders. Aurora MedClaims results from four years of SDLC work, and we launched our SaaS service last January 2021.
To be the leading developer of process-driven Software Systems on the cloud platform for business application by different industries.
To help our clients achieve business growth and profitability by delivering reliable software solutions, with creative design and development that create value and relevance to customers.