Insurance/HMO

Insurance/HMO

Healthspace is cutting-edge software that includes all the functions needed by HMOs to manage the full settlement of claims for health insurance. Both retail policies and group-business claims can be managed using a single system. Easy steps are provided by a front end driven customization to configure the items for various insurers.

Claims processing is simple and economical thanks to built-in workflow management and smart queuing. With the use of its client communication modules, customers may quickly and easily set up communication to be sent through SMS, email, or WhatsApp to stay updated on the development of their claims.

Because of its unique ability to implement insurer SLAs, adherence to insurer processes is entirely system-driven. Faster and more accurate claims processing can be assured by using system-based validation of terms and conditions and Provider Tariff Management.

A smooth flow of communication is guaranteed by the ability to communicate with foreign entities such as providers, insurers, and intermediaries.

Features:

• Manage product settings for several insurance companies.
• Auto adjudication built-in system.
• Configure the corporate buffer, while processing claims.
• A case tracking tool from start to finish.
• An integrated and comprehensive grievance management system in one single place.
• Simple document management software.
• Intelligently designed system with distinct ceilings for inpatient and outpatient care. Limit capping connected to employee count.
• Set limit caps for a wide range of categories, including dental, ophthalmology, chronic or pre-existing disorders, and other urgent circumstances.
• Activate policy registration and card printing.
• Customizable dashboards for granular reporting.
• Easy-to-use web portals for navigation.
• Sync with SMS, email, and fax systems.