MediCare is a complete solution for health insurance management. By eliminating back office processes such as manual claims handling and invoice processing, the health insurer can use MediCare to cut costs and focus staff attention on service improvements for patients and healthcare providers.
Sales people gain a competitive edge because they are free to spend time with each customer to design exactly the right policy. They can rely on MediCare to provide automatic premium pricing based on the customer’s risk profile.
Healthcare insurance attracts more claims than other types of insurance and smaller claim amounts, rendering manual claims processing ineffective. MediCare applies business process management to policy, claims and money management. Once a policy is running, MediCare manages regular subscription payments via different retail banking systems and automates claims procedures.
Customers can use a web portal to open claims directly in MediCare or use their health insurance scheme membership card to make the claim. The customer puts the card into a card reader, which is remotely connected to MediCare, and receives an immediate response on the card reader’s screen. An automated limits check can be imposed where required. Claims data is continuously available to the insurer and customers can also track the progress of their claims online.
Built on Microsoft’s core technologies, MediCare can be securely integrated with the existing business systems of partners, such as healthcare providers. As well as being able to register claims, partners can also directly book insurance, with extended information exchange between a partner portal and the insurer’s systems.
MediCare offers the following functionality:
- Automated claims handling
- System integration
- Web registration for partners
- Web portal for customers
- Cards based claims handling
- Policy management
- Proposals and quotes
- Claims management
- Money management
- Incoming/outgoing invoices
- BankGiro
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