Important Documents from other Implementations

 

Function

Nepal

Tanzania

Congo

(DRC)

Chad

Mauritania

Niger

Cameroon

(BEPHA)

Cameroon

(HIV UF)

Function

Nepal

Tanzania

Congo

(DRC)

Chad

Mauritania

Niger

Cameroon

(BEPHA)

Cameroon

(HIV UF)

Collection of public health data (location of health facilities (HF) , types of HF, related services, population covered)

 

 

 

 

 

 

 

 

Presentation of the users of the application :
users, roles management

 

 

 

 

 

 

 

Manuel d'utilisation plateforme OpenIMIS

 

 

Administration of beneficiaries (members and their dependents)

Manual (1st part)

 

 

 

 

 

 

page 26 manuel de procedure HIV User Fees

 

 

Collection and management of contributions 

 

 

 

 

 

 

 

 

Information on eligibility for benefits

 

 

 

 

 

 

 

Page 18 manuel de procedure HIV User Fees

Issuance of membership cards to beneficiaries 

 

 

 

 

 

 

 

 

Checking eligibility for benefits (insurance coverage)

 

 

 

 

 

 

 

checking test vih code tarv

 

Use of health care services (access to benefits; coverage)

 

 

 

 

 

 

 

processus de gratuite dans les fosa

Elaborating of claims statements 

 

 

 

 

 

 

 

page 27- 28 manuel de procedure HIV User Fees

Submission of claims for reimbursement of benefits

 

 

 

 

 

 

 

page 21 manuel de procedure HIV User Fees

 

Medical review of claims

 

 

 

 

 

 

 

page 39 manuel de procedure HIV User Fees

Preparation of claims payment statements

 

 

 

 

 

 

 

 

 

page 30 manuel de procedure HIV User Fees

Claims payment

 

 

 

 

 

 

 

page 30 manuel de procedure HIV User Fees

Generating indicators: membership, contributions, claims, health services use etc.

 

 

 

 

 

 

 

 

Import and export data from/to other applications

 

 

 

 

 

 

 

 

 

 

Annex

  1. Manuel Operationelle/Operational Manual for Cameroon HIV User fees

2. Standard of Procedures/ Standard des procédures (Nepal)

3. Standard of Procedures/ Standard des procédures (Nepal) Employment Injury Insurance

Employment Injury Insurance - Social Security Fund Nepal

4. Functional Scope - The Gambia

Gambia: Scheme workflows and openIMIS adaptation - openIMIS - openIMIS Wiki (atlassian.net)

 

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