Gain operational and financial insight.

Dynamic management, financial and administrative reports.

Graphical presentation of reports – bar graphs, pie chartsReports by client, society, age, home area, diagnosis, tariff, branch.

Age Analyses and various financial analyses reports.

Income statements.

ICD-10 reporting & analytics

Bills List – lists all the generated bills. Enables filtering by date and billing cycle

Income Analyses by Fund – a breakdown of revenue, showing # number of bills, total value, total outstanding.

Corporate Invoices.

Corporate Member Statements.

Detailed Corporate Bill.

Manage Benefits Definitions.

Claims List – this lists claims, using filters by:

Payment batch

Payee

Fund

Date treated, received, captured, paid

Shortfall status

Banking details availability

Diagnosis

Payment Status

Award decision

Amount paid

Overpaid claims – this show claims paid above the set tariff amount when the policy is “pay in full”

Claims with Tariffs – this is similar to the report in (1) except that it is itemised, showing the details of each claim

User-defined report – this is a report defined by the user in terms of what columns are shown and printed

Claims data capture report – this tracks the rate of data capture by users.

Claims capture statistics.

Provider’s claims age analysis (condensed report).

Symptom prevalence table and graph

Claiming trends by tariff Code

Funds Consumption by Benefit

Claiming Trends by Age/Gender – age group, total value, outstanding, total paid, average per-claim

Claims Analysis by Provider.

Reimbursement Claims Overview.

Benefits Utilisation Overview.

Members' Benefit Utilization.

Benefits and Rejection Reasons Overview.

This feature is for setting up the service providers.

>Multiple practitioner registration (e.g AHFoZ) numbers per provider. A provider can have multiple entries as long as each one has a unique practice registration number.

Providers who are contracted (preferred provider network) are so indicated using this feature.

Banking details are managed thru this feature.

Default decision regarding payment of claims can be set here:

Pay – All Ok

Pay – on hold

Don’t Pay – Warning

Don’t Pay – Fatal

Their EDI files decryption password is set here

Their tax clearance status is set here

The service units at their facility are indicated using this feature

The columns of membership reports are user-defined

The following filtering parameters are used for each report:

Fund

Current Status (Active, Suspended, Terminated, Black-listed)

Date of Birth

Join-date

Principal Members only

Date captured

Last membership event

Card printing status

Record verification status

Account balance (plus, minus or zero)

Report can be printed

Report can be exported to CSV or XML

Send personalized SMSes to all listed in report

Drill down into more detail about each listed member.

Membership data capture report – shows the number of new members captured by each user.

This feature is used to configure various aspects of the system:

There are actions which are automatically logged when they occur

This report shows these actions, along with the user and time