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SmartCare™
Mega online Medical/Healthcare Benefits Information and Claims Processing System
Many employees of the governments and private corporations today are covered by a variety of healthcare insurance schemes. Different employees may be entitled to different levels of insurance coverage. These insurance schemes are not easy to understand and figuring out the benefits, coverage and entitlement is a challenge. These information needs to be shared, tracked and managed accurately so that the healthcare providers can determine exactly what specific services the patient is entitled and the right amount of co-payments can be collected from the right parties.
Stratech introduces a web-based online medical benefits and claims information and processing system specially developed for Governments, Major Corporations, Healthcare Insurance Companies and Healthcare Service Providers offering cost savings and increased productivity through central management and processing of healthcare benefits and medical claims information over the Internet. Built on centralized and standardized services such as access control, interactive voice response and Web-based queries, the system provides a real-time and reliable electronic means to access and submit accurate medical benefits and claim information. Stratech Systems has implemented SmartCare™ that addresses the above challenges for Singapore's entire Civil Service. Launched in April 1999, SmartCare™ is currently being used to centrally manage and provide online and up-to-date information on the healthcare benefits and medical claims of all the 200,000+ employees of the Civil Service of Singapore, and their dependents.
Unique Features:
- Developed using open industry systems standards as a secured intranet application that is accessible over a wide area network through phone lines, leased lines and the Internet
- Built on centralized and standardized services such as access control, interactive voice response and Web-based queries
- External interfaces to organizations include Web, IVR, RPC, FTP and Email
- Easily customized to meet additional requirements, including integration with existing information systems
- Scalable to handle many concurrent connections from many agencies and users
- Capturing of entitlement records from various Entitlement Agencies into a central entitlement database
- Web-based maintenance of medical schemes
- System to System (RPC) and batch validation for the entitlement by Healthcare Service Providers
- System to System and batch proration of medical bills from Healthcare Service Providers
- Interfaces with Payment Agencies to effect payment to Healthcare Service Providers
- Interfaces with Recovery Agencies to effect recovery from employees.
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