Healthcare insurance-webport business
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Transcript of Healthcare insurance-webport business
IntroducingE-SOLUTION
Idea brings Money
INTERNET TRANSACTION SERVICES
Healthcare Information Technology
WEB Portal
Product Information
Policy Information
Product Prices
Price List Comparison
Eligibility Checks
Suggestion Ranks
Cardholders Statistics
# of Patients Visited in MC
Approval
Eclaim
Rejections
Resubmission
Medical Team
HIS
TPA Services
Insurance ERP
Internet Transaction Services
SERVICES
Our Center of Attention
31 Insurance Companies Over 3 millions Insurer 897 MC + 59 Hospitals
Insurance Insurer HealthcareCompany Centers
Medical Centers+ Hospitals
Integrated Business Growth
EligibilityChecks
E-ClaimManagement
Services
HIS
20%50%
65%90%
ApprovalManagement
Rejection Management
Policy InfoProducts InfoRate ComparisonFor us only
Invoices and Supporting DocApproved Case
Rejection
Re-Submission
Consultancy
Medical Team
•Auto•Accidents•Commercial•Property
Medical Team
Integrated HIS
On monthly Installment
Server Based Storage Facilities
OMR 0.010 baisas per case
Original Cost plusMonthly Commission For claim checksEmployer Registration Fee for insurance help
Claim Checking
HIT
Integrated
•1000 OMR Medical Center•3000 OMR Hospital•Maintenance Fee – Yearly15% of total price•Data Storage Fee – to be determined
To be determined after observing the volume of work
Online Support to employer
Services Covered
Healthcare services
Healthcare Information System
TYPE_01 TYPE_02
01Healthcare
CS Support, Policy Info, Eligibility, Updates
02Insurance
Insurance services
Free Support Free Support
65%
35%
Approval processing
Claim processing
Medical Claims
Brokers
SEASON_002
Product Support, Policy Support, Marketing Ceiling in initial phase, Updates
Elig
ibili
ty
Checking
Policy info
IT Support
Marketing
Pro
duc
t Suppor
t
Policy Support
CS Support
Break the Market by new Invention/Features Sys
VVIP Smart Card
Core Attribute• No deductible applied on Corporate/Govt• Maximum Services covered• Maximum Limit Covered• Zero Wait Policy• Best technique for Advertisement & RetainValued Customer for long run.• VVIP Protocol
Card Issuing Criteria (Just swipe your card, place a finger and process for your treatement)System Integration, Policy and Procedure would be developed after approval from the Employer. The validity of cards & its benefits would be fixed according to awarded policy by company.
For VVIP, A+ card holders, Corporate Sectors
Project Team
Business Solution ManagerIT ManagerWeb developerWeb designerHardware EngineerComputer Programmer
**Procurement of assets such as Server, IT Rooms, and other equipments for storage would be decided after the market survey, as per users capacity. Phase wise Action plan would be submitted in the Proposal.
5 years experienced in asp.net, sql server, oracle database and php, plus BCS
Revenue very flexible in first year
Awarding Products – TPA•Initially 3% gross Claimed amount from Medical Center or as agreed•Second phase up to 12% from gross claimsApproval via web pages
•10 baisas per document to be received from Medical Centers/Hospitals
E-Claim Web page uses10 baisas per document uploading OR3% gross claimed Amount ORfixed amount to be charged to Medical center and Insurance Companies for using E-claim facilities
Policy UpdatesoFree for first year, or as agreedoCharge Annual Fees to Insurance Companies for using our web page.
Product InfoUpdates Products, rates, procedures free, package included in the annual fees
E-Claims Checking by our DoctorsActual cost plus commission from insurance companies ORA Fixed amount to be charged to Insurance companies
Revenue very flexible in first year
Data Storage Fee•Annual Fees from Medical Centers and Hospitals to be charged against Data Storage
Rejections Re-submissionDocuments fee would be charged to Medical centers as per rates.
EmployeroOMR 200 Annual Fee to be charged to Employer those would utilize our online services for Insurance product comparison, obtaining knowledge, price comparison and MIS Reports
Insurance ERP 3000 Monthly ERP Fee But would be decided after completion of HIS
HIS ERP1000 Monthly Fees from Medical Centers3000 Monthly Fees from HospitalsAnnual Maintenance Fees from both
Approval Facilities by our DoctorsActual cost plus commission from insurance companies ORA Fixed amount to be charged to Insurance companies
Competitors
Competitors Zero, GCC countries waiting for new invention to save their precious time among the healthcare, Insurer and insurance companies
There is only one web page in KSA launched by waseel.com with limited facility of eligibility & Insurance Approval facility, they are improving their standards as per the Market requirements
Presenting by [email protected]