Insurance Services Gateway (ISG) is a platform that enhances the operational standards of Health Management Organizations (HMOs), by providing them with a more convenient and effective way of communicating and sharing information with their Clients and service providers. This is done without replacing their already existing operational infrastructure.
ISG comes with built-in features and processes which prevent fraudulent activities while its simplicity, multiple access channels, session support and high availability, make it the ideal platform for subscribers to access Insurance services irrespective of time and location.
Due to the complexity in managing different HMO platforms, Providers now have a standard, centralized gateway which gives them access to any HMO they are registered with as well as manage them in one place
Basic Functions of the Platform include
Works on all GSM mobiles (especially with the provision of the USSD channel).
Secure multi-channel communication.
No application installation required.
Individual enrollment management.
Verification of enrollee membership status and details.
Verification of active plans on a policy.
Medical Pre-Authorization and Post-Authorization process management.
Hospital Check-in/visit history.
Built in User Authentication and access management.
Preliminary Claims filing process management.
Insurance Services Gateway (ISG) provides a wide range of functionalities such as:
Calling and waiting for your HMO to check the policy status of an Enrollee has now been eliminated, as Providers and Enrollees can now check Enrollees’ policy status to know basic details of the Enrollee’s plan within seconds.
Providers are now able to check-in an Enrollee to begin treatment procedures upon initial policy verification with just one click.
The Treatment Tracker keeps a record of all kinds of treatment given to Enrollees. It is built in a simplified manner to help Providers prepare invoices for claims. This also helps to eliminate paperwork and enhances the Provider's service delivery to Enrollees of different HMOs.
ISG automates the PAT process by enabling Enrollees and Providers to seek approval for elective medical procedures from the platform. Upon request, the HMO is notified through their preferred channel and a response is provided to the patient and provider along with with its schedule, service location availability and approval limits.
Our Insurance Services Gateways can keep track of all medical procedures the Provider administers to Enrollees, thereby making claims filing easy. The open and yet secure communication provides real time details of treatments logged by Providers for efficient reporting and claims filing
ISG has built in a high level of intelligence to help track the activities and transactions of users on the platform. ISG provides insurers the ability to quickly and accurately detect, investigate and prevent insurance fraud, while minimizing the impact on genuine customers.
ISG improves the efficiency and effectiveness of HMO's and Providers’ operations while enabling scale at a reduced cost without demanding the overhaul of existing infrastructure; all of which leads to higher profitability and better service delivery.