Health claim investigation

Reduce Turnaround Time for Health Claim Settlement with On-Field Investigations

Health Insurance Claims Investigation Solution is an enterprise mobility solution, that helps to increase productivity of your health claims investigators and reduces turnaround times for your customers

Overview

Execute a guided process for health insurance claims investigation, using a versatile 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

 

    • 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.

 

  • 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
    • Obtains details of hospital and treating doctor
    • Gathers 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 Turnaround Time

    Reduce health insurance claims investigation turnaround time, leading to faster decision making

  • Optimize Efficiency

    Auto compile comprehensive health claim investigation reports and digitize data at source

  • Improve Decision Making

    Capture reports and audio-visual evidences in digital format to help in accurate decision making

  • Enhance Operational Agility

    Ensure faster inspection case assignments with location tracking of health claims investigators

  • 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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