Billing and regulation of eHealth providers
We deliver a comprehensive and powerful core system that ensures smooth and maximally automated operation of all health insurance agendas and smooth integration of the system. We implement all necessary components of the main information system and superstructure systems including their mutual integration and communication.
We supply health insurance companies with software for:
- Health care reimbursement,
- collection of insurance premiums,
- registration, integration and communication,
- modelling, analysis and statistics.
- The most comprehensive solution for health insurance companies on the market
- Long-term experience
- Possibility to integrate with a number of state institutions
- Availability of a portal or web application for the insured persons
- Full use of the legislative framework for financial management efficiency
- Healthcare reporting, extensive validation checks including very sophisticated processes
- Reviewing doctors' agendas, submitting selected care to reviewing doctors for their required analysis
- Ongoing healthcare billing and generation of billing reports
- Annual billing, so-called regulation and settlement
- Finding patterns of errors and fraudulent behaviour
Collection of insurance premiums
- Checks on payment discipline,
- The likely amount of the premium,
- Reports of self-employed persons,
- Arbitration committees.
Records, integration and communication
It uses a very extensive internal and external integration with systems of state institutions such as the Ministry of Health, VZP, SÚKL (State Institute for Drug Control), UZIS (Institute of Health Information and Statistics), ISZR or Insolvency and Commercial Register.
Connection is also possible to the systems of healthcare institutions, insurance payers and also to the ZP Portal.
Internally, the system can be connected to the filing service, accounting system or, for example, to the call centre.
We will link the superstructural portal and mobile solutions to the Internet banking - we will enable payment via the payment gateway, payment button, QR payment, etc.
Authentication will be provided according to the customer's choice by bank identity, citizen's identity or through our own authentication gateway ARICOMA ID.
Modelling, analysis and statistics
- economic indicators,
- status and development of the number and structure of the insured population,
- trends in reported healthcare,
- key economic and healthcare data for management,
- Prediction of the exit of insured persons (churn analyses),
- Non-standard phenomena in care reporting (support for fraud detection).
Portal and mobile solutions
The solution allows the insured persons to:
- Have their current health information at hand at all times, including the care that they have received.
- Share their health information with their doctors.
- Schedule and order health care appointments.
- Find out the availability and navigation to a doctor or pharmacy.
- Communicate with their health insurance company and make necessary payments.
Solution for managing and recording data reports of the General Health Insurance Company of the CR
Development of the VoZP health insurance system, including health care reimbursement
Development of the core system of the Vitalitas and online arranging of travel insurance.
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