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December - 2016 - Special issue > Company of the Year - 2016: Smart Card Technology

Acess Meditech: Addressing Complex Insurance Challenges with Smart Tech Health Insurance ERP Solutions - TOSHFA

si Team
Wednesday, January 4, 2017
si Team
In the age of robotic surgery, keeping bundles of health insurance papers may seem sardonic. As the misuse of medical benefits and other frauds have grown rampant in the past few years, many governments are now turning towards 'Smart Card' for capturing medical records of people. Smart health cards can improve the security and privacy of patient information, provide the secure carrier for portable medical records, reduce healthcare fraud, enable compliance with government initiatives and mandates, and provide the platform to implement other applications as needed by the healthcare organization. According to Credence research report,the global smart card in healthcare informatics application was valued $580 million and is projected to cross $1 billion by 2022. Though healthcare insurance companies are extensively issuing Smart Cards, they are hassling to manage compliance risk at best, given all the requirements governing the insurers' underwriting and distribution processes. To address the pain points of prevailing insurance market, being an insurance expert himself, Mr.Syed Aijazuddin ventured Acess Meditech Pvt. Ltd. on March 2007 from Hyderabad. The company provides proficient integrated business process and outsourcing services to governments and healthcare insurance companies.

Robust & Flexible Solutions
Healthcare is subject to ever-increasing regulations, and mandates continue to grow in complexity. When enrolments happen at the insurance company side, insurance companies have to keep an army of people for enrolment, customer verification, card issuance and card processing. While teams often are in place and a lot is spent to meet these requirements, many fail to get control of what composes up to 80 percent of all documents: paper forms. Using Acess's advanced Medical insurance specific solution TOSHFA, with this customised user friendly platform companies can go complete paperless and handle 40 percent business more effectively. TOSHFA aids in management of underwriting quotation, proposal, policy conditions, loading, discounts, deductibles, endorsements, and renewal processing, and helps setup of proportional and non-proportional treaties under reinsurance module by defining their treaty limits on the sum of the insured in percentages or flat amount. TOSHFA is extremely capable of handling various facets that involve financial accounts Payable and Receivables, Reconciliation, Reports & MIS, Customer Administration and billing &payment processing."We help the clients businesses achieve uniformity and integrity, curtailing the operational cost and significantly reducing system maintenance costs," asserts Syed.

Acess's integrated health insurance management system TOSHFA provides very friendly interfaces to manage medical insurance operations such as underwriting, policy administration, approvals, claims and reports. This smart card integrated solution uses Biometric technology for member verification and allows a high degree of customisation enabling online approval and claim processing for customers. The web-based application offers payers claim level views into the electronic claim filling from claims submission to the payer organisation. Acess enables payers to perform claim searches, verify claim status and generate a variety of trending claim reports. TOSHFA is totally automated solution which is capable of bulk upload and processingof over Lakhs of claims without any manual interruptions in a given day. This product has been implemented at every process checkpoint of major insurance companies in Middle East and African region (MENA) and has successfully delivered maximum volume of output for increased return on investment. Acess's solutions provide seamless integration into existing claim flows and the application of intelligent rule-based pre-adjunction reduces man-power and yields significant financial savings for the clients. For forecasting and addressing key obstacles in the areas of growth, Acess has received huge appreciations and referrals from its clients.





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