Cost-efficient

With in|sure Health Claims you benefit from a standardised industry solution with all the associated cost benefits which will relieve your budget and pay for itself in a short space of time.

Automated

The wide-ranging automation of a large number of insurance processes releases staff resources for your core business.

Holistic

Our software for managing insurance pay-outs encompasses all pay-out-related processes, interfaces and their configuration, plausibility and product customisation.

Flexible

A mature interface concept supporting uncomplicated integration vis-a-vis every system context.

Leading technology

in|sure Health Claims are based on a framework which has been granted the XCelent Technology Award for technical innovations.

Adaptable

Open frameworks offer optimal adaptation to your own systems and interfaces. In addition, individually necessary processes can be defined simply.

Features of our product:
- Simulation options for treatment and cost plans, and recourse proceedings
- Generation/management of test cases
- Payment clearing with open items
- Commissioning/managing care needs assessments
- Generation of reports (private health insurance pool reports, Pharmaceutical Market Restructuring Act or AMNOG etc.)
- Support for automated auditing of accounts
in|sure Health Claims give you a cost-effective tool for managing insurance benefits, giving you all the freedom you need to adapt it to your situation and also freeing up staff resources for your core business. And also supports you with the following functionality:
- Black box processing of incoming benefit claims, taking into account rules specific to the customer in question
- Automated verification of insurance pay-outs due
- Option of automated allocation of processing times, taking account of a change of year, a change of tariff, a change of insurance year or interruptions
- Automated calculation of a refund due
- Option of limit account management for automated calculation of deductibles, maximum rates and tooth scales
- Automated deduction of hospital daily benefit or compensation to cover hospital daily benefit
- Automated recalculation of past invoices based on tariff changes or corrections
- Automated consideration of promises made when calculating a refund due
- Automated separation and amalgamation of benefit claims
- Establishing, maintaining and managing statutory tariffs (mandatory nursing care insurance / mandatory nursing care insurance for civil servants, basic tariff, standard tariff, emergency tariff)
- Quality control of benefit claims (two-man rule), bearing in mind individual customer rules

MIGSuite

To achieve more automation, SOKA-BAU migrates its policy portfolio

By using MIGSuite, SOKA-BAU can migrate its inventory in a timely and legally compliant manner and subsequently process previously manual work steps in the new inventory system in the dark.

Case Study
Aissac

Advocard legal protection insurance

With AISAAC, ADVOCARD was able to significantly reduce the processing time for new claims through dark processing.

Case Study
in|sure Health Claims

INTER Krankenversicherung: Using a system to automate long-term care services

With in|sure Health Claims, INTER health insurance optimizes its workflows in the service management of long-term care insurance.

Case Study
in|sure Health

Migration of 400,000 contracts despite shortened duration

The introduction of the policy management system and the claim management system took place without any major disruptions.

Case Study
MIGSuite

Barmenia: Migration of 1.3 million contracts

With in|sure Health Policy, Barmenia now has a modern and future-proof policy management system.

Case Study
Insurance in the Cloud

andsafe: New digital insurance

For the foundation of the new digital commercial insurer andsafe, Provinzial Nordwest was given a complete application landscape in the cloud.

Case Study
in|sure PSLife

Debeka Insurance Group: Flexible system for flexible products

The aim was to offer flexible, unit-linked products in addition to traditional ones. For this, Debeka needed a flexible system. The in|sure PSLife calculation kernel was used.

Case Study
MIGSuite

Barmenia Versicherungen: Contract migration on time

The MIGSuite data migration software made it possible to transfer contracts to the new system of Barmenia Versicherungen.

Case Study
in|sure General Claims

INTER Versicherungsgruppe: Automated claims processing

Employees of the INTER Versicherungsgruppe can now process claims automatically without having to change systems.

Case Study
in|sure Health Claims

Münchener Verein: New claims system for more quality

The introduction of in|sure Health Claims enabled the Münchener Verein to reduce costs and the potential error rate enormously.

Case Study

Policy management
Health Insurance

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Policy management
Health Insurance

Policy management system for private health insurance companies, offering a high level of process automation, plausibility checks, monitoring and straight through processing of all business transactions.

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Partner system
All lines of insurance

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Partner system
All lines of insurance

Partner management system that enables a holistic view of the customer as a divisional solution or a comprehensive group application.

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Collection/disbursement system
All lines of insurance

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Collection/disbursement system
All lines of insurance

Collection/disbursement system for subledger accounting, with which all processes in payment transactions are carried out cost-effectively, quickly and at the same time highly automated.

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Contract Management
Life Insurance

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Contract Management
Life Insurance

Policy management and benefit system that provides all products and business transactions of a life insurance company in a configurable way.

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Evolutionary management of benefit pay-outs for private health insurance.

6 good reasons for in|sure Health Claims:

Cost-efficient

Automated

Holistic

Flexible

Leading technology

Adaptable

Do you need more information on in|sure Health Claims? You can find our brochure here