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These automated checking processes within openIMIS are fixed, and not configurable by the user. While it is possible to configure the time between claiming of the same service resulting in rejection, it is not possible to add new checks on other fields. A configurable rules engine that will enable the automatic assessment of claims in by testing against various knows scenarios (eg. what services cannot be claimed for a particular diagnosis) would heavily ease the workload for the claim review team of the scheme operator.
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| Configurable Claims Review Engine |
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| Configurable Claims Review Engine |
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| Automated Claims Adjudication |
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| Automated Claims Adjudication |
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