Winsoft Solutions L.L.C

Transcription

1 Winsoft Solutions L.L.C Do i.t professionally Add-Vantage Insurance Management System for TPA and insurance companies (Add-Vantage - IMS) DHA & HAAD compliant info@winsoftsolutions.net (+971)

2 Add-Vantage- Insurance Management System Integration Options Multi database support, the system has the ability to integrate with other third party solutions Supported databases Oracle, MS SQL Server, DB2 etc.. Highlighted Features Arabic, English web based portal for all your validation Easy payment / Pay as you go! Multi companies support Multi currencies support Multi finance segments Integrated modules SMS & notification support

3 Add-Vantage Insurance Management System Add-Vantage Network Underwriting Quotations Management System Approvals, Helpline, CS, and Claims Portals, SMS And communication Auto Premium Calculation Methods Medical Edits Rules Engine Mobile APP Standard Edits (AR,CMS, AMA, etc.) Finance PBM And more. HR and inventory

4 Add-Vantage- Insurance Management System What is Add-Vantage IMS? The Add-Vantage Insurance management system is a web based ERP application designed to control and manage the process in insurance companies and third party administrators, it works in modular bases which allows the different departments to interact and meet their needs for maximum functionality and usability Add-Vantage has all the international aspects and configuration to match the maximum of the clients requirements over the world, It has been built in such way to allows you customized the functionality and the templates behind in the way suite our valued customers needs The major client in UAE are Neuron, NGI, Globe Med and more

5 Add-Vantage Network Module Network is a group of functionality screens which covers all the process needed such as Providers Providers Contacts Provider Billing Details Mandatory Tariff Provider clinicians Providers pharmacy Tariff Providers license Providers reports Providers internal codes mapping and more Standard codes Support the international coding classifications ICD 10CM and ICD9CM CPT, HCPCS, DSL, ASL and Drugs etc.. Which match all the DHA and HAAD Uploading Standard Codes Compare provider prices and limit them to the mandatory tariff and more

6 Add-Vantage Underwriting & Quotation Management Underwriting is where the quotation and policies taking place in the system and mange the CRM related details with brokers, clients and agents etc.. Agents Renewals Brokers Reports Billing details Portals for brokers, agents and Groups groups Members Uploading Standard Codes Exclusions Premium calculation based on PBM Pharmacy benefit management reinsurer rates, fixed networks, integration ages, gender etc Edits Rules Engine integration Manage the pipe line quotation Finance integration and the quotation revisions Claims integrations Manage the portals and portal And more requests

7 Add-Vantage Approvals and Helpline Approvals and help line, The system has the ways for end user to respond for any enquiry and have a huge criteria of search for all the modules (members, claims, policies and reports etc ) Search and approve any approval request Approve Search and approve any enquiry by reference or caller information automatically by integration with the phone system Integration with the SMS, s and other notifications Search the available balances and benefits consuming before giving a new approvals Ability to trace the client requests and respond with the live data for claims status and approval status enquiries because the system is linked with the claims and other department The integration with the finance allows the helpline to provide more accurate and direct information to the clients

8 Add-Vantage Claims & e-claims Approvals and help line, The system has the ways for end user to respond for any enquiry and have a huge criteria of search for all the modules (members, claims, policies and reports etc ) E-claim, integration with DHA and HAAD e-claims Paper claims Reimbursement claims Linked with the approvals so the system will check the claims activities dynamically and check whether to approve it or not Direct integration Add-Vantage medical edits engine with the eligibility and the policies Integration with the Add-Vantage Drubs database which is based on PBM database check Integration with the SMS, s and other notifications Productivity reports And more

9 Add-Vantage - Drug Database Our drug data is the most extensive on the market today and includes: Trade names, generics, herbals, OTCs and supplements Drug interactions checker Drug-allergy checker Patient education handouts Adult dosing Pediatric dosing Nomenclature mapping (NDC, SNOMED, NDDB, etc) Warnings and alerts Contraindications Indications Mechanism of action Adverse drug reactions Kinetics/Dynamics Pregnancy/Lactation Overdose Mgmt Interactions Trades/Cost Info Evidence-based practice recommendations Nursing Considerations

10 Add-Vantage Clinical Content Our specialty-focused clinical information easily transforms any HIT system into a comprehensive reference tool for healthcare professionals. Disease profiles and clinical conditions Specialized content for each department Symptom checker Medical calculators Emergency protocols and algorithms Evidence-based practice recommendations Illustrations for patient education Diagnostic tests

11 Add-Vantage Drugs Interaction Check for possible interactions between a patient's entire medication regime including prescription, OTC, herbal, supplement or foods. The most powerful drug interaction checker available, Winsoft Solutions provides a ranked listing of all possible interactions, and a description of each reaction. Incudes: Drug-drug Drug-allergy Drug-nutrient Drug-alternative medicine Drug-food Features: Identify drug interactions and minimize adverse events Ranked by severity Description of each interaction No redundant information Customized alerts

12 Add-Vantage Supported Countries Our Database includes drugs from all these countries: Middle East: United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore Thailand Australia: Australia New Zealand Africa: South Africa North America: Canada United States Latin and South America: Argentina Brazil Chile Mexico Venezuela Europe: United Kingdom Austria Belgium Czech Republic Sweden Switzerland Europe: Denmark Finland France Austria Belgium Czech Republic Denmark Finland France Germany Greece Hungary Iceland Ireland Italy Netherlands Norway Portugal Russia Spain

13 Add-Vantage Implementation Options Cloud Web Services Integration Database Access / License Per Member Or Per Claim Online Public Portal Choose your comfort option and request a demo Contact us for presentation or proposal

14 How Can Winsoft Solutions Help? Improving distribution management with collaborative customer knowledge OPERATIONAL EFFICIENCY CUSTOMER EXPERIENCE DISTRIBUTION MANAGEMENT

15 Winsoft Solutions Contact us For further information please contact us U.A.E. Dubai +971 (4)