his page is only an idea of implemention from Patrick Delcroix , not validated nor reviewed by the community
In order to go beyong health openIMIS need to gain some features:
Configurable Workflows So the claiming can be reviewed by the right team depending on the type of claim (also some process will require multiple approvals which are not yet supported)
Payment and accounts to be able to deal with many sort of payments
Rights management: to define the different right possible (salary replacement, pension, accident compensation ….) and to manage active rights
Claim/Active Rights Audits : to validate the veracity of the claim, current feedback process is too weak)
claim cash payment: be able to claim a cash payment (new born, COVID one time support … )
claim rights: to claim the activation of a right
(nice to have) reinsurance
On the modeling parts:
the cash payment and the rights should be linked to a product in order to know which issuree are “cover“ for the right and to get contributions (alike product service and Item)
claim cash payment and claim right should be linked to a claim meaning that the claim screen should allow adding such right or cash payment (may depend on the claim type)
active rights would be a instance of their own, still linked to the product through the right they implement
Claim/Active Rights Audits should also be dedicated object that might change the status of the claim or rights (put it as suspended for example)
