In 2012, while working with a major medical aid society on some backend software projects, we learnt that our country faced a challenge emanating from the low computerization level in the healthcare industry. To be more precise, health service providers generally did not have computers and were also inclined to stick to paper-based systems for managing their clinics. This was making it impossible for medical aid societies to advance towards electronic claims processing. This impacted the funders heavily in terms of claims processing costs, processing volumes and difficulty in curbing fraud.
We took it upon ourselves to address this anomaly. We began by developing a Claims Management System, whose primary function was to capture claims and formulate them into Electronic Data Interchange (EDI) formats. Over years, we have continued growing and refining the product with the vision of delivering an end-to-end solution: a medical ERP. Thus, we now have a very comprehensive Advanced Healthcare System, dubbed ‘UtanoX’ (Utano-Exchange). It serves the different disciplines including GPs, Emergency Rooms/ICU, Laboratories, Pharmacies, Specialists, Surgeons, Dentists and Rehab Centres. Thousands of users have used our systems and thus enabled us to correctly mirror the needs and preferences of the industry. We have begun serving across the border and we are going to have an ISO Certified Medical ERP which has global acceptance
The UtanoX platform provides a wide variety of services including servicing as a switch to enable medical claims in electronic form, along with their feedback to be exchanged between healthcare service providers and medical aid/Aid companies. The platform also provides other services to enable specialists to collaborate on patient cases for better resolution of conditions and the maintenance of a universal health record. This, however, is to be rolled out only within legal frameworks acceptable within the various territories across Africa and beyond.
We have since corroborated all our experience, exposure and expertise to build an advanced HealthCare Funds, Benefits & Claims Administration which has already been in use in the country for a few years. We have paid much attention to detail and built a comprehensive, light and versatile claims adjudication engine, above and beyond the basic features expected. This is a product which addresses many concerns around contemporary solutions and is covered extensively in our technical proposal.
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