Health claim investigation

Reduce Turnaround Time for Health Claim Settlement with Live On-Field Investigation

‘Health Claims Investigation Solution’ is an enterprise mobility solution, that helps increase productivity of your health claims investigators and reduce TAT for your customers, with an intuitive mobile app to investigate cases, prepare and submit reports directly from the field

Overview

Execute a guided process for health claim investigation, using the health claims investigation solution, comprising of a web portal and a mobile app, that can be easily built on iNube’s proprietary B2B mobility platform – ‘Evidens’.

  • Upon intimation of admission to the hospital by the insured, the claims officer from the insurance company, requests an on-field investigation, using the Evidens Sky Portal
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  • The assignment of investigation to a specific on-field claims investigator may be based on location, work load or any other business rule as defined by the insurance company.
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  • The claims investigator receives the request in his/her Health Claims Investigation Mobile App and executes the investigation –
    • Captures details of patient, ailment, diagnosis and treatment
    • Captures details of hospital and treating doctor
    • Captures images, audio-visual evidence
    • Initiates live streaming with claims officer and receive guidance
    • Mobile app generates health claims investigation report including all evidences captured
    • Submits report directly from field to the claims officer

Solution Features

Learn more on how our ‘Health Claims Investigation’ solution is a perfect fit for your critical on-field investigation operations

Geo-Coordinates

Bird’s eye view of location, view maps with geo co-ordinates

Document Upload

Capture images of relevant documents and attach to the health claims investigation report

Workflow Driven

Enable users across multiple levels to review and refine the health claims investigation report, prior to submission of exhaustive report to the claims officer

Offline Capability

Gather information including geo-coordinates even in offline mode. Network connectivity is required only at the time of report submission

Versatile Controls

Scan documents, take photos, record video/audio, digital signatures to support case

Increased Convenience

Automatic generation of health claims investigation report in PDF format

Enhanced Security

Encrypted data storage and dual factor user authentication

Value Proposition

  • Reduce health claims investigation ‘Turnaround time (TAT)’
  • Capture reports and audio visual evidences in digital format and reduce costs
  • Auto compile comprehensive health claim investigation reports
  • Faster health claims decision making
  • Ensure faster inspection case assignments with location tracking of on-field health claims investigator
  • Digitize data at source and eliminate human error
  • Issue1 Real Time Quotes/Policies

    Instantly generate quotes and issue policies. Reduce load on your core insurance system

  • Provide Quick Turn Around Time (TAT)

    Delight your customers by providing quicker turnaround times for policy issuance, renewals, endorsements

  • Ensure Greater Flexibility

    Allows insurance companies to configure different privileges for pricing, underwriting and operations to
    different intermediaries

  • Gain Better Oversight

    Take complete control over your distribution network with configurable levels of pricing and underwriting
    privileges

  • Increase Transparency

    Manage complex commission structures and make payments online

  • Be Eco-friendly

    Help the environment by enabling end-to-end paperless process for policy issuance

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