Evolutionary manage­ment of benefit pay-­outs for private health insurance.

in|sure Health Claims give you a cost-effective tool for managing insurance benefits, giving you all the freedom you need to adapt it to your situation and also freeing up staff resources for your core business. And also supports you with the following functionality:

• Black box processing of incoming benefit claims, taking into account rules specific to the customer in question
• Automated verification of insurance pay-outs due
• Option of automated allocation of processing times, taking account of a change of year, a change of tariff, a change of insurance year or interruptions
• Automated calculation of a refund due
• Option of limit account management for automated calculation of deductibles, maximum rates and tooth scales
• Automated deduction of hospital daily benefit or compensation to cover hospital daily benefit
• Automated recalculation of past invoices based on tariff changes or corrections
• Automated consideration of promises made when calculating a refund due
• Automated separation and amalgamation of benefit claims
• Establishing, maintaining and managing statutory tariffs (mandatory nursing care insurance / mandatory nursing care insurance for civil servants, basic tariff, standard tariff, emergency tariff)
• Quality control of benefit claims (two-man rule), bearing in mind individual customer rules