Inube - Case StudiesReduced claim processing times with digitised claim management for a leading stand-alone health insurer

September 27, 20210


The Challenge

The customer was experiencing a growth phase and was looking to modernize and scale up their IT systems to cope with increased load. iNube introduced several cutting edge capabilities including workflow enabled claim processing based on financial limits, digitised provider management & Schedule of Charges (SOC), TAT configuration, Case management etc.


The Solution – Health Insurance Claims Management

iNube decided to replace the current systems with a single comprehensive claims platform. It leveraged its flagship platform - ClaimsLive Health, to meet the requirements of the Customer.
Comprehensive end-to-end platform to handle complete claim adjudication process from intimation to settlement
Rule engine with front end UI to enable business users to define rules for fraud detection
Exhaustive Case Management module to configure medical protocols and drug & implant masters to identity any deviations from standard line of treatment
Suspect cases could be flagged for investigation with integrated investigation mobile app
Extensive reporting capability to help drive analytics


Value Delivered

Reduced manual activities with introduction of workflow enabled claims processing
Replaced physical file processing, integrated with DMS and digitized most activities
Helped identify deviations from standard line of treatment, medication, length of stay with case management
Customer recognized for the ‘Best Claims Service Provider of the Year’ at Insurance India Summit & Awards 2018
26000+

Average number of claims processed per month

5000+

Hospitals empanelled

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