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Page Properties

Country/Region

Nepal

Scheme Operator

Social Security Fund Nepal

Scheme type

Employment Injury Insurance , Health Insurance (formal + informal), Migrant scheme

Implemented since

2020

Implementing Partner(s)

GIZ Nepal, ILO

Supporting Partner(s)

Financial Assistance: German Development Cooperation

Version

v1.5.1 (build 2021.4.12.1030)

Functionalities used

  • Claims Management

  • Claims Review

  • Reports

Coverage

Nationwide

Number of beneficiaries

406,00000,000 beneficiaries (1,5 Mio enrolled)

Number of users

-

Number of health facilities

110

Last update

Dec 2021Jun 2024

Scheme Features

Scheme implemented since
Note: This can be different from openIMIS implementation start date

2020

Number of products managed by the scheme and using openIMIS

2

Number of households covered

N/A

Average size of a household

N/A

Total number of employees using openIMIS

-

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Version

v1.1.3 (build 2021.4.12.1030)

Has anything been modified (customization)

Customizations done for interoperability with SSF’s in-house beneficiary and payment management system (SoSYS).

The Insuree Balance booking mechanism has been added via REST API. This update ensures that the balance and premium are updated in real-time during the eligibility check. The live balance check is now seamlessly integrated, providing accurate and up-to-date financial information for users.

What standards are used to code services, items, diagnosis and products

ICD 11 for diagnosis

Internal coding mechanism (same as HIB Nepal) for services and items

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