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HEALTH CARE

Today, we are the preferred service provider for many leading companies in healthcare industry because of our commitment & the quality of our products. We offer product engineering services and claims processing solutions through healthcare platforms.
We have designed & developed web based applications like Permanent Health Record (PHR), Health Risk Assessment (HRA) & MY TPA etc for healthcare companies, by using XML technology. We have developed these applications by using expertise in ASP. Net, c#, Java script, AJAX & database expertise in SQL server 2005.

Product TPA:
TPAs are licensed by Insurance Regulatory Development Authority (IRDA) to act as a Third Party Facilitator between Insured & Insurer. Our product for TPAs offers the following:

  • Total benefit administration including hospital, daycare, and clinic claims processing.
  • Rich, high performance reporting for at-a-glance access to the information you need in just a few keystrokes.
  • Automated Preauthorization Workflow for high speed processing of preauthorization's received by fax or electronically.
  • Advanced correspondence logging for single click access to Word documents, emails, or Excel spreadsheets previously sent to clients or insured, along with SMS and email push features.
  • Direct integration with PHR (Optional) Automated Scanning System for quick claims turnaround and minimal data entry.
  • Automated Electronic Claims Queue Processing for Streamlined processed of claims.
  • Open Architecture Database design allows access to data by your existing applications or reporting tools.
  • Full HIPA compliance including security tracking, patient security features, and acceptance of all HIPAA data formats.
  • Real-time integration with MY TPA Web Access System site for instant access to claims status and eligibility via the web for insured and providers.

Product PHR:
PHR maintains a permanent health record on the web which is a lifelong archive of a person's medical history. It can be accessed online anytime, anywhere, and by anyone with the required security credentials.

Permanent Health Record contains:

  • Basic personal information
  • Medical insurance coverage details
  • Immunization records
  • Medical history (past & current)
  • Medication information
  • Information of Allergies
  • "Smart Tag" technology that keeps track of members information as a critical care access report which can be accessed in the case of a medical emergency
Important points to know about a Permanent Health Record?
Medical records can be maintained by both
  1. Provider: - Holds information about your current health and sustained by every healthcare provider.
  2. You: - PHR holds information about your history & current health record maintained by you.
Benefits of PHR
  • 24*7 access and handy source of entire medical history
  • Pro-active approach to tackle emergencies
  • Increased consciousness towards one's own health
  • Life time health insurance records and health checkup records
  • Online health record accessible
  • Members will be able to add, edit or upload new record as and when required
  • Unique identification (username/ password) for everyone
  • We can upload the scanned copy of original documents 100% Accuracy

Product HRA (Health Risk Assessment):

  • Health Risk Assessment is the assessment of severity or likelihood of an adverse health outcome due to an exposure to environmental, biological or social conditions.
  • This is an individual/employee health assessment that helps in being conscious about lifestyle management.
  • HRA helps in identifying & managing risks for different diseases. It is beneficial for program planning, implementation & evaluation. HRA reports also can be used for the research purpose & in policy development.
  • Considering advantages & limitations of the self reported data, we can use it to make our workplace more effective & efficient; by selecting right tools for the right jobs. However we need to keep in mind that HRA is not a clinical evaluation. Also, we can not neglect ethical considerations.
  • In simple terms, HRA is a useful & cost effective tool for improving health at the primary, secondary & tertiary stages of health if utilized appropriately

Product Health Checkup:
Health Check up is a Business Optimization of Process of Employment Annual Health Check up system for the Employees by Corporate and Insurers. It is intranet/internet based web application providing common platform to their corporate, individual, hospital provider & management where they can interact with each other. Following are the features:

  • Integrated accounts module that takes care of invoices, debit note & Payment Received.
  • Facility to customize the packages and rates for each Diagnostic Center, Corporate.
  • Separate Logins for Agents, Development officers, Insurance companies, Corporate.
  • SMS and E-push integration throughout the system for periodic updates.
  • Reporting of all processes, all appointments, TAT reports, and accounts reports
  • Annual health checkup for corporate is available.
  • Exhaustive MIS for Corporate, Providers, Administrator.
  • Reports can be fetched in various formats as per the requirements.

Product Tele – Underwriting:
Teleunderwriting is a new tele-interview underwriting system for proposers seeking medical insurance policies.
Features
Immediate risk analysis - Our system enables the interviewer to analyze the risk for more than 40 common diseases on the spot.
Effective Call center office automation – Optimizes the use of your call center and office manpower to save you money as well as increase efficiency.
Health Data gathering – Which can be useful to insurance companies as well as the Ministry of Health.
Benefits

  • Increase productivity - spend less time on paperwork and more time doing what you do best meeting with clients and selling.
  • Improve turnaround time - more detailed information to the underwriters, which reduces the need for the most time-encompassing requirements.
  • Alleviate awkwardness - Applicants often prefer providing personal information to a third-party interviewer rather than face-to-face with an agent who may be a friend or associate.

 
 
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Testimonials
Praful Bhalerao, CEO,
Health Quarters "I would hereby put on record, that we are extremely satisfied with the projects delivered by Eximius "