Paper-based systems make the exchange of data between patients, health service providers and scheme operators slow, inefficient, and susceptible to errors and fraud. Ultimately, this can lead to health insurance schemes becoming financially unviable. Digitalisation results in more efficient data management, helps to streamline business processes and provides the information needed to monitor a scheme’s performance.
openIMIS supports the following business processes for health insurance
Beneficiary Management
Collecting and managing contributions
Issuing membership ID cards to beneficiaries
Verifying scheme membership
Health service claims generation and submission
Medical review of selected claims
Processing and payment of claims