CGHS/ECHS suite will provide the functionalities to manage the Central Government Health Insurance Scheme and Ex-servicemen Contributory Health Scheme. Solutions Suite provides the advanced framework for the automation of health insurance Preauth & claims administration management.
Claims Management is done with the applicability of defined rule engine as per the requirement of CGHS/ECHS.
Solution Modules
- Provider Network Management
- Provider Category management
- Provider Tariff and Rate Sheet Management
- Automated Claims Validation (With defined rules engines)
- Preauthorization Management
- Claims Management
- Payment Management
- Master Configurations Management
Benefits
- Automation of Tariff and Rate sheet Validation
- Automation of Product Validation
- Automation of Policy clauses and Member Benefits Validation
- Automation of Member Entitlement Validation
- Automation Policy and Member Eligibility Validation
- Minimize Manual depended Errors
- Minimize TAT for Preauth and claims process
- Increases Efficiency and Accuracy in authorization Process
- Increases resources Productivity
Preview
