Health Claims Management Software

Health Claims Management Software

Enabled Effective Control & Management Of Health Insurance Claims for a Leading TPA

The Challenge

The client, a leading third-party administrator (TPA), formed by the joint venture of major public sector general insurance providers in India, was looking forward to –
• An advanced technology suite in health insurance claims processing
• Alignment of the solution with its corporate vision
• Adopt industry best practices
• Bring in greater efficiency in its core processes
• Enrich customer experience

The Solution – Health Claims Management Software

iNube effectively addressed the client’s challenges and concerns by implementing an end to end health claims management software solution and customizing our flagship product ClaimsLive Health – A new age integrated platform for management of health insurance claims.

  • Adopted a greenfield development approach of building a new health insurance solution from the ground-up
  • Simplified the business processes in a multi PSU driven health insurance set up
  • Digitized provider rates for enhanced service
  • Set up business rule engine to efficiently tackle the complexity of data
  • Sophisticated benefits administration

Value Delivered

  • Automation of claims handling process
  • Standardized data exchange
  • Detected & prevented fraud leakages through Business Rule Engines
  • Quick Turnaround Time (TAT) to acknowledge claim submission & settlement
  • Reduced grievances from customers and providers

3000+

Network hospitals currently empanelled in the system

100,000+ Claims

Processed till date

1500 Claims

Received per day

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