Save costs on Health Insurance Claims through Digital Processing
Brand Distinction Through Fast, Accurate, and Secure Claims Settlement.
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!
Business Benefits
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Reduced overhead costs that positively impact the net revenue performance of the company, maximization of work efficiency, ability to launch and support new products, or change in policies in the market with the least IT intervention.
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Enhanced customer experience through our Mobile App created and designed for policyholders/members, contactless and paperless transactions not only promote process efficiency but also support telecommuting and maintain safe workplaces.
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End of the hazards of billing – the shift from evaluating paperwork to clear-off payments to the automation of the adjudication process that will handle them safely.
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Data security and visibility – data ownership and administration belongs to you that can be accessed in real-time anywhere by authorized users; assurance of data maintenance and security (HIPAA standards-compliant).
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High usability – cloud-based transaction processing and storage are highly accessible; software applications on the cloud do not leave any “footprint” and are dependable Business Continuity Planning (BCP) strategy for companies.
Healthcare Industry Ecosystem
Integrating various modules and users to streamline and enhance claims management processes This system ensures efficient interactions, providing a comprehensive solution for managing healthcare claims with improved coordination, accuracy, and speed.
E2E Claims Management on Cloud
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
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
- Generation of Management Reports
