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CGHS, ECHS

CGHS/ECHS suite will provide the functionalities to manage the Central Government Health Insurance Scheme and Ex-servicemen Contributory Health Scheme. Solutions Suite provides the advanced framework for the automation of health insurance Preauth & claims administration management.

Claims Management is done with the applicability of defined rule engine as per the requirement of CGHS/ECHS.

Solution Modules

  • Provider Network Management
  • Provider Category management
  • Provider Tariff and Rate Sheet Management
  • Automated Claims Validation (With defined rules engines)
  • Preauthorization Management
  • Claims Management
  • Payment Management
  • Master Configurations Management

Benefits

  • Automation of Tariff and Rate sheet Validation
  • Automation of Product Validation
  • Automation of Policy clauses and Member Benefits Validation
  • Automation of Member Entitlement Validation
  • Automation Policy and Member Eligibility Validation
  • Minimize Manual depended Errors
  • Minimize TAT for Preauth and claims process
  • Increases Efficiency and Accuracy in authorization Process
  • Increases resources Productivity
 

Preview

 

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