Idea: Claim resubmission
Content
Summary
This was edited from the idea “editing a claim”. It was deemed that editing a claim should not be allowed for fraud control purposes, rather it is more interesting to focus on the claims resubmission process. Indeed, it should be more clear exactly what the “standard” process should be if a submitted claim is incorrect and needs to be altered. This is particularly interesting for new implementations and programs that in the process of setting up a health insurance scheme, such as in Niger and Mauritania, where the claims management procedures are not necessarily in place yet. If the openIMIS Community could provide a standardized process on claim resubmission, scheme administrators would then already be guided on best practice when using openIMIS.
Overview
| ||
---|---|---|
Function | Claim resubmission |
|
Source |
|
|
Related |
|
Prioritisation
Score | 9.3 |
---|---|
Current Relevance | 8 |
Future Relevance | 10 |
Global Good | 10 |
Local Funding | Need to see perhaps Nepal or Cameroon HIV scheme can potentially take this up in their implementation |
Source
This was edited from the original idea “editing a claim”. It was deemed that editing a claim should not be allowed for fraud control purposes, rather it is more interesting to focus on the claims resubmission process.
Child Pages
Did you encounter a problem or do you have a suggestion?
Please contact our Service Desk
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. https://creativecommons.org/licenses/by-sa/4.0/