Healthcare Benefits Administration system helps to automate benefit validation and administration processes. It is fully capable of configuring all types of healthcare insurance products such as retail, group and government funded healthcare schemes at the most granular level. It helps in the configuration of health insurance products including benefits, covers, limits, co-pay, deductibles, exclusions etc.
ClaimsLive Health, our state-of-the-art and customizable health claims management software offers an exclusive Healthcare Benefits Administration Module that is fully capable of configuring health insurance products including benefits, covers, limits, co-pay, deductibles, exclusions etc.
The healthcare benefits administration system seamlessly maps benefits of ICD10 codes and enhances efficiency of health claims processing by automatically classifying permissible and exempt limits. The scalable and versatile system can be deployed independently in order to augment an existing health claims management system for validation.
What can be configured?
An API can be provided for each of items configured under each plan. On receiving an API call, the ‘Benefit Administration’ module can provide you with inputs on whether the claim condition is covered or not.
Leverage the various benefits of Healthcare Benefits Administration system and ensure seamless claims processing
Expose readily available APIs for third parties to consume, easily integrate and collaborate
Benefits mapped to ICD 10 codes make processing of claims more efficient by automatically classifying permissible and exempt claims
Configuration capability of 70K ICD codes
Supports a wide range of products such as retail products and multiple sub plans, group health insurance products and multiple plans. Self-funded social sector schemes, government plans and hybrid plans
Replace time consuming manual checks and validations of benefits and limits with automated benefit administration system leading to quick turnaround times
Facilitates straight through processing of Pre-auth/Claims with real time claims data
Instantly generate quotes and issue policies. Reduce load on your core insurance system
Delight your customers by providing quicker turnaround times for policy issuance, renewals, endorsements
Allows insurance companies to configure different privileges for pricing, underwriting and operations to
different intermediaries
Take complete control over your distribution network with configurable levels of pricing and underwriting
privileges
Manage complex commission structures and make payments online
Help the environment by enabling end-to-end paperless process for policy issuance
Interested to learn more about Healthcare
Benefits Administration Module?
Join the conversation with us.
Follow us on LinkedIn.
Enable motor claims investigators to digitally conduct on-field spot investigations, with audio-visual evidence
Optimize your resources and TAT, with a pluggable software solution to live stream on-site audio video content
Request Demo
x