JBM’s Health Insurance management solution is designed for INSURANCE COMPANIES who offer Medical Insurance services and THIRD-PARTY ADMINISTRATORs (TPAs) for medical claims administration. The solution is developed keeping in mind the needs of the GCC and in specific compliance with the regulators. The solution is well integrated with JBM’s financials, thus ensuring end to end business automation for Medical Insurance service providers.
Complete claims management originating from multiple sources can be swiftly processed and settled with complete financial accounting.
Process your claims and prior authorization automatically and respond with approval or rejections to avoid manual intervention to handle volume of transactions.
Completely configurable basic and advanced rule engine can help you adjudicate the claims and prior authorizations swiftly with complete audit trail.
Rule engine can help you set custom rules to control the frauds and abuses thus ensuring the total cost control on the claims.
Solution is compliant to the needs of DHA, HAAD and SHAFAFIYA to manage complete operations across the UAE.
Solution provides number ready reports and also customized report options to meet the challenges of reporting to the principal insurer.
Insurer portal gives a direct access to the insurance companies to access the policy, census and claims related data in multiple formats and outputs.
You can choose to get the provider to interact with you online via the portal access for managing prior authorizations and claims management.
E claims management helps you process online electronic requests in integration with DHA, HAAD and SHAFAFIYA.
Total automation for accounting of invoice, claims settlement and also revenue recognition. The calculation of all the finance documents are automated.
Solution is capable of integrating with the insurer using multiple methods such as API, EDI and alternative methods. This allows real time data exchange with the TPA and the INSURER.
JBM Financial accounting integration means just in time, accurate accounting. Eliminates all sorts of redundancy in the bookkeeping process.
Numerous internal as well as external notifications keeps the operations team aware of important tasks.
Go paperless with JBM’s Green Vault.Now you can attach electronic documents as a permanent document for future reference.
You can put any of the operational documents though the work-flow process and ensure that there is a control in every step.
