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I2 Healthcare Management System
The I2 healthcare management system retains the best of iMed, its predecessor, but also incorporates enhancements built on experiences attained in developing, installing and supporting the latter, to cater for the dynamic managed care environment. Financial system independence, improved web integration, cutting-edge technology, complemented by a flexible and competitive pricing structure, makes this the most comprehensive solution available in the market.
The I2 application is designed to support the configuration and administration of multiple medical funds with different rule sets, an unlimited number of products, benefit limits and pricing structures per fund, on a single platform. I2 is a technically robust solution that can easily be modified or enhanced to meet the client’s specific needs and provides seamless integration into the existing or preferred financial system.
- High level of flexibility
The user-friendly, parameter-driven design provides a high level of flexibility when defining benefits as well as contribution and payment rules, enabling the fund to react to market changes with minimal effort.
- Real-time claims processing
I2’s on-line, real-time claims processing function provides an environment that ensures consistency and accuracy in the processing of all disciplines. The handling of claim documents, pre-authorisations, inclusions, exclusions, disease management and clinical auditing are integrated into this process.
- Powerful query capabilities
I2 provides powerful query capabilities which enable the prompt and accurate handling of queries. In addition, access to full payment records is available.
- Auditable electronic data interchange
A fully integrated Electronic Data Interchange (EDI) ensures rapid claims processing, enabling staff to deal with more complex claims. The EDI facility provides a comprehensive reconciliation of received and processed data.
- Document management supports client service
I2’s document management supports the access to and retrieval of documentation (e.g. various file formats, faxes) according to practice, member, group or claim; furthermore contributing to improved client service.
- Membership and contribution management
I2 makes provision for automated member eligibility adjustments. These adjustments are immediately and automatically applicable to all claims, including claims already paid.
- Advanced medical savings account management
I2 supports new generation medical fund products and provides advanced support for savings account management - empowering the member to effectively manage his/her own savings account.
Making provision for the full control of disease management, I2 ensures that the controls are integrated into the claims process and that the fund does not incur any unnecessary costs. Should the member exceed an authorisation or limit, claims and clinical audit personnel are alerted accordingly.
I2 includes the full set of practitioner data as supplied by the Board of Healthcare Funders. The solution also makes provision for an internal classification to assist with reporting and benefit calculation.
Clinical validation is key for detecting fraudulent claims where services are not allowed to be claimed together, or when restricted by the patient’s age and/or gender or where additional information of a clinical nature is required to process the claim successfully.
I2’s advanced security control enables the user to easily set up access on various levels within the application and its functions.
With a full dimensional data model, I2 can provide online operational information on membership, scheme profitability, claim processing, queue management, as well as provider, episode and patient analysis,
An internet based application to manage work requests from clients and their respective customers.
An internet based application to manage all I2 & iMed interfaces.
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