Health Insurance & e-Health

The Health Insurance and e-Health Integrated Suite of INTRASOFT INTERNATIONAL is a highly scalable and highly configurable Integrated Platform which supports and automates the business processes within a Health Insurance Organization in a National level, supporting also electronically the primary health care process.

Our Solution has successful presence in the Health Insurance incorporating services that allow the different types of actors (such as medical doctors, hospitals, private clinics, diagnostic centers, rehabilitation centers, pharmacies, patients, etc.) to collaborate electronically in order to produce the necessary electronic claims data reimbursed by the Health Insurance Organization.

Our offer is a Health Insurance and e-Health solution built upon cutting edge technology (J2EE, HTML5, SOA, Workflow-BPM, rules engine), in order to:

  • Meet the needs of a Health Insurance Organization in short term.
  • Support statutory requirements (rules and legislation) in a standardize way.
  • Provide Health data Standardization (HL7, ICD, GRD, ATC, GMDN, etc.).
  • Control electronically the claiming demands, monitor the workflow load, and finally increase the efficiency, effectiveness and quality of the business processes.
  • Abandon manual processes by automating and electronically supporting the business processes.
  • Integrate Primary Health care (Electronic Prescription from GP’s).
  • Manage Health Expenses by applying electronic control mechanisms within the business processes that generate the expenses.
  • Enhance digital services and interoperability between systems.
  • Move the Organization to contactless and paperless processes.
  • Utilize the digital information in order to re-adjust the strategic policies and support sustainability of the Organization (utilizing MIS and Data Analytics for Decision making).
  • Increase efficiency and quality of medical treatment, supported by the EHR of the system

In high level the components of Intrasoft International’s Solution that support and automate the vertical business processes are the following:

  • Health Products and Services
  • Health Care Actors Registries
  • Classifiers and Nomenclatures
  • Health care Pricing Policies and Contracts
  • Medical Services (e-Prescription)
  • Outpatient e-Health
  • Inpatient e-Health
  • e-Authorization Services
  • Health Care Benefits (Reimbursement to Members)
  • Claims Clearance and Payments (Reimbursement to Health Care Providers)
  • EHR (Electronic Health Record)

supported horizontally by common modules like:

  • Workflow (Embedded BPM Engine)
  • Embedded Knowledgebase and Business Rules Designer (Rules Engine)
  • ‘Machine to Machine’ Interoperability Services
  • Financials
  • MIS-Data Analytics
  • Risk Analysis and Compliance