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Old Version 6

changes.mady.by.user Uwe Wahser

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New Version 7

changes.mady.by.user Sunil Parajuli

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Page Properties

Country/Region

Nepal

Scheme Operator

Social Security Fund Nepal

Scheme type

Employment Injury Insurance , Health Insurance

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

40,00, 000

Number of users

-

Number of health facilities

110

Last update

Dec 2021

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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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