This document summarizes the openIMIS features related to beneficiary enrollment. These features are spread into the Persons & Families, Policies and Contributions modules.
openIMIS aims to support the beneficiary enrollment workflows defined in the Background - Joint Learning Network for UHC . The following table provides the list of current openIMIS features, how they support JLN workflows and which part of the JLN workflows are not (yet) covered.
JLN Processes Beneficiary Management | JLN Processes Premium Management | ||||||
|---|---|---|---|---|---|---|---|
Insuree Enquiry | x | ??? Today, inquiry “by provider” seems to be managed via insurance product scope (down to district only - not HF level) QUESTION: does the openIMIS enquiry take the user’s registered HF (/location) into account?? | x (note: openIMIS makes a distinction between medical service and medical item) | NOT COVERED by openIMIS (validation only at claim submission) | |||
Find Family | x | x | |||||
Family/Group Overview | x | x | |||||
Family/Group Page | x | ||||||
Adding a Family | x | ||||||
Editing a Family/Group | x | ||||||
Changing a Head of Family/Group | x | ||||||
Moving an Insuree | x | ||||||
Deleting a Family/Group | |||||||
Find Insuree | x | x | |||||
Insuree Page | x | x | |||||
Adding an Insuree | Partially:
| Legacy UI (master branch) only foresee geolocalization (no PCP). Database however does foresee PCP (probably used in country customizations) >> new UI will add PCP | |||||
Editing an Insuree | |||||||
Deleting an Insuree | |||||||
Find Policy | x | ||||||
Policy Page | x | ||||||
Adding a Policy | Partially:
| ||||||
Editing a Policy | x | ||||||
Deleting a Policy | |||||||
Find Contribution | Partially: openIMIS allows to record a contribution (and updates policy status accordingly) Process foresees invoice sending, reports (due premiums,…) | ||||||
Contribution Page | |||||||
Adding a Contribution | |||||||
Editing a Contribution | |||||||
Deleting a Contribution | |||||||