Some schemes require that a health facility requests a pre-authorization of a treatment from the insurer before they administer it to the client in order to have the assurance that the costs will be covered. For eg. expensive treatments like certain type of heart surgeries might require a pre-authorization request to be approved by the insurer (including indication of amount to be blocked from the patients ceiling) before the hospital undertakes the surgery. Request is derived from Service Desk issue reported by users in Egypt captured in OSD - 42The product OpenIMIS should apply to different target groups. It is necessary to separate the target groups. Primarily because of the necessity that different target groups can receive different service packages.
This is not only about the allocation of molecular services in terms of male/female or adult/child but also about whole groups of people like e.g. formal sector workers informal sector workers pensioners civil servants prisoners
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