Social insurance schemes can protect workers and their dependents in the case of occupational injuries and diseases. Such schemes ensure that injured workers have access to the health and rehabilitation services they need, and that they or their survivors promptly receive cash benefits to compensate for loss of income.
openIMIS helps to manage information flows related to employment injury insurance processes by bringing together employee, employer, healthcare provider and payer data into a single platform. Its simple
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openIMIS offers a range of functional modules which can be combined into tailored solutions for the delivery of specific social protection schemes. The employment injury insurance solution powered by openIMIS allows scheme operators to manage beneficiaries, employers/employees, contracts, products, contributions, providers, claims and accounting in a single software. Its easy-to-use accident reporting system and efficient claims procedures can help to ensure that workers or their survivors receive benefits promptly.
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Supported processes
openIMIS supports the following business processes for employment injury insurance:
EnrolmentEnrollment
Employer/employee management
Accident reporting
Health service utilisationutilization
Health service claims generation and submission
Claims review process
Salary compensation calculation
Processing and payment of claims
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For employees, openIMIS simplifies enrolment enrollment procedures, makes it easy to verify one’s coverage status at point of care and ensures prompt receipt of benefits in case of injury. For employers it provides a one-stop solution for managing both enrolment enrollment and accident reporting, with seamless links to information from hospitals about treatment and rehabilitation. For health facilities, it streamlines the processes associated with a health financing scheme and makes it easy for them to receive reimbursements. For scheme operators it reduces operational costs, allows for better monitoring and analysis of the scheme’s overall performance, and enables information to be shared between different health and social protection schemes.
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Visit the wiki page or download the factsheet for this openIMIS use casesolution:
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