openIMIS is a versatile open source software which supports the administration of various schemes related to health financing and social protection. Designed in accordance with industry standards for interoperability, openIMIS offers a standardised but adaptable way to manage information flows related to various forms of health insurance, employment injury insurance as well as other social protection schemes by bringing together beneficiary, service provider and scheme operator data into a single platform. Some key use cases of openIMIS are highlighted below.

Use cases in health financing

Health insurance

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

Current implementations

Tanzania Mainland

Cameroon

Nepal

Zanzibar

Use cases in social protection

Employment injury insurance (EII)

openIMIS supports the following business processes for EII

• Enrolment

• Accident reporting

• Health service utilization

• Health service claims generation and submission

• Claims review process

• Processing and payment of claims

Current implementations

Employment Injury Insurance - Social Security Fund Nepal