ClaimsLive Health - End-to-End Claims Management
by iNube Software Solutions Private Limited
A Comprehensive Platform for End-to-End Health Claims Management and Fraud Detection
ClaimsLive Health, is a new age state-of-the-art technology platform, that provides end-to-end health claims management and prevents claims fraud with effective control and management of health insurance claims – right from enrollment to settlement.
The modular platform comes with mobility extensions for on-field activities, with
secure cloud storage to help investigate fraudulent and suspect claims with
real-time data, through Live Video Streaming.
Who are the Users of this Solution?
- Insurance Claims Team
- Providers
- Members (Corporate & Individuals)
- Third Party Administrators (TPAs)
- Corporate HR
- Claim Investigators
- Regulators
Salient Features
1.
ICD 10 Based Benefit Administration
2.
Fully Digitized Schedule-Of-Charges (SOC), Tariff, Billing Policies
3.
Supports Retail Health Policies, Group Health
Policies and Social Sector Health Schemes
4.
Role Based Privileges and Configurable Workflow
5.
Highly Configurable Business Rule Engine
6. Exhaustive Stakeholder Portals
Value Proposition
Provide Quick Turnaround Times
Boost claims auto-adjudication rates by straight through processing of Pre-auth/Claims and enhance operational efficiency
Reduce Claims Leakage
Eliminate inconsistencies in the claim management process and prevent over payments and errors
Reduce Claims Fraud
Enable auto flagging of claims, assign suspect cases for investigation and capture suspect claims details
Enhance Customer Engagement
Real-time flow of data from the field with accurate evidence enables faster claims processing
