Health Platform

WHAT WE OFFER

HEALTH PLATFORM

Digital platform designed to be modular, cloud ready, data-driven, and scalable. Once developed, it will include 9 modules and channel applications (e.g., app, website, distribution channels’ portals)

ROADMAP

The Health Platform is ready for localization in the different geographies

A module that will simplify product design and management, ensuring the highest level of usability and integration between core systems and providing a single entry point to manage all insurance products

Centralizes product configuration in a single system. Increases business autonomy, reducing dependency on IT teams

A module that will simplify and standardize the invoice process for existing and future policies, integrating the policy data into the financial system

Offers a higher degree of flexibility in terms of billing, for instance the possibility of having Split Billing Invoicing

A third-party solution that will manage in and out of network claims system, integrated with insurance benefits and policy configurations, with clinical rules and pre-authorization processes integrated

High degree of automated claims processing and possibility to have clinical editing rules to control fraud, waste, and abuse

A module that will standardize the invoice generation process and commercial tariffs enabling the premium calculation, commissions calculation and coinsurance calculation

Centralizes pricing configuration in a single system. Increases business autonomy, reducing dependency on IT teams

Master of the policies information, it will integrate with the remaining modules, or other legacy systems. When triggered, it will create, adjust, or cancel policies according to the business rules

Standardizes and automates the policy issuance, servicing, and cancelation

A third-party solution that will integrate network management, with the possibility to configure agreements per provider and manage several networks of providers

High degree of flexibility in terms of network management and contract configuration

A module that will enable the business to define process workflows, acceptance criteria and process automation across the whole policy lifecycle

Enables rules’ definition and implementation by business; Operationalizes decision automation; Triggers approval workflow

Defines premium correction rules for the renewal process, assuming premium reduction/increase control levers and risk data-driven segmentation impacts

Simulation of portfolio renewals (e.g., enabling elasticity renewals analysis), increasing business autonomy to define renewal rules

A third-party solution that enables the monitoring of claims and providers network, aiming to detect anomalies, fraud, and abuse

Superior fraud detection and consequent claims’ cost reduction

Channel
Applications

Upgraded mobile app, responsive websites and portals ready to export, with multi-language and multi-currency factors

The upgraded channel applications will enable an integrated experience across several stakeholders, guaranteeing a seamless experience across different channels:

Customer B2C
Scalable Website & App

Customer B2B
Corporate website (for corporate and SME customers)

Agents and Brokers
Agents & brokers portal for quoting and decentralized policy insurance

Providers
Providers portal to process claims, submit and manage pre-authorization requests

We have become digitally relevant within insurance companies as all Médis digital applications are market-aware. Our channel applications are built according to a Médis’ Design System, which ensure that all applications are always up-to-date with UX best practices, under the health insurance landscape.