Please describe about insurance sytem in 500 words
AFYA-IGS OVERVIEW
Covers group life and health products
Product Setup
Product management and customization
Benefit
Premium Setup
Custom plan with Family Limit
Administrative service only (ASO)
Term & Condition
Profit Sharing
Reinsurance
Policy Holder
Proposal
Underwriting
Policy setup
Policy document
Membership
Member addition / alteration / deletion with upload function
Alternation of :
Product
Plan
Limit amount
Termination / deletion with premium refund
Membership certificate
Renewal
Termination / deletion with premium refund
Billing Premium
Create billing (new business, renewal, movement)
Billing notification
Additional billing (letter, invoice, report)
Billing correction and adjustment
Collection of billing premium from policy holder and member.
Sales management
Agency, broker, referral
Commission setup
Commission calculation
Commission aggregation
Commission adjustment
Commission payment
Commission refund
Policy owner service (POS) modules
Integration to agency system
Integration to TPA systems (member from enrollment) and accounting / finance system using file / API
Reports, letters, and dashboard
Claim (next project)
Cashless
Membership data
Claim verification
Excess claim management
Reporting to TPA
Claim list
Claim payment
TAT
Internal claim checking and validation process
Claim payment
Reimburse
COB (BPJS & Other insurance)
Provider management
Term and condition
Hospital discount
Reasons Switching to AFYA-IGS
More than 10 years experience in healthcare industry.
Existing systems do not guarantee that all the necessary information is available when and where it is needed.
Existing systems are difficult or not integrated so that with many logins and different interfaces, it burdens the users who use them, as well as patients.
Existing systems hinder the ability of insurance to measure outcomes effectively and implement standardized process, which in turn slows revenue growth.
Availability of a dedicated and comprehensive online training module using the proven open Learning Management System, namely edX. This online training has been divided into roles and modules, making it easy to use.
Group System Functional Diagram
Reasons Switching to AFYA-IGS
Platform: Java based, using Spring Boot 2.6.7, which can be deployed on premise or cloud
Application Server: Tomcat 8.5
Framework: Spring Boot
Database: Oracle 11
User interface: HTML, CSS, JavaScript, AJAX, jQuery
API: RESTful Web API
Operating System: Linux / Windows
Server: REHL 8 / Ubuntu 13 / Microsoft Windows Server 2019