Mediclaim/Cashless

Overview

Newgen’s Claims Automation solution offers powerful and userfriendly functions catering to the complete lifecycle of a claim. It
features components for efficient Data Capture, Settlement Creation, Authorization and Approval Processes, Payment Tracking, Salvage and Recovery Tracking, Legal Matter Processing, Communication Management and Monitoring. The components seamlessly work together to make case processing more efficient, accurate, and productive. The claims automation solution covers both Life and P&C insurance claims.

Key Features

• Process Management – Dynamic business process management based on defined characteristics and process exceptions
• Business Rules Management Engine – Dynamic rules facilitate straight-through checking of various policy breach conditions; hence, helping the claims officer’s decision to approve/reject the claim
• Flexibility and Management of Workflow – Workflow flexibility ensures that a carrier can perform to its promised levels of customer responsiveness at all times. Further, it enables carriers to control overhead, labor and data storage costs, while bridging costly gaps between business processes
• Efficient Data Capture – Configurable user interface to define data elements as per specific requirements
• Increased Collaboration – A secure shared workspace on the corporate intranet or an external web site facilitates cooperation among all parties to a claim and shortens the time it takes to settle the claim
• Standard Integration Architecture – Seamless integration with third party and legacy applications such as Core Policy System etc.
• Communication Platform – System based triggering of text and mails to customers as well as internal employees at relevant business stages
• Dashboards – Sophisticated data analysis that goes far beyond canned standard reports