A versatile open source solution for employment injury insurance schemes
openIMIS is an open source software which supports the administration of social protection schemes. Designed in accordance with industry standards for interoperability, openIMIS offers a standardised but adaptable way to manage information flows related to employment injury insurance processes by bringing together employee, employer, healthcare provider and payer data into a single platform.
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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.
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
Benefits
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.
Example workflow
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Current implementations
Further information
Download our Visit the wiki page or download the factsheet for this openIMIS use case heresolution:
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As contributory social insurance schemes for employment injury gain in favour, there is a growing need for digital solutions which can help to manage the complex information flows involved. An effective accident reporting system and simple, efficient claims procedures are needed to ensure that workers or their survivors receive benefits promptly. Paper-based systems make the exchange of data between employees, employers, healthcare providers, and insurance scheme operators slow, cumbersome and susceptible to errors and fraud. Digitalisation allows for more efficient data management, helps to streamline business processes, and provides the information needed to monitor a scheme’s performance.