Health

Health Core for Insurance Entities

Home » Solutions » Health » Health Core for Insurance Entities

The health platform provides the technological support needed by insurance companies that do not only process benefits but also manage the health of their policyholders.

The Digital Health Platform offers a complete solution for the needs of any health system, public or private. This tool makes the company more efficient while responding to the health needs of customers. As it is flexible and modular, it adapts to the insurer to complement existing solutions.

It is not easy to provide good service in the context of health and sometimes illness. For Delonia, the solution is to strengthen the link between the insured and the insurance company and for the latter to have much more control over the care experience it is covering. Success lies in optimising the interaction between the insured and the actors in the process. Digitize each step and let the insurance company direct this journey.

Video-consultation, supplier management, automatic authorization of services, online appointment, digital prescription, fraud management and many more functions are available in our solution. We digitize processes, integrate systems and offer mobile and omnichannel accessibility. The Platform’s functionalities respond to the needs of the client/patient, the provider/doctor and the insurance company.

We have developed solutions within the Healthcare 4.0 framework that enable digital transformation and increase the agility, performance and competitiveness of healthcare systems. We offer a suite (package) of products independently or together, always adapted to the context of each client.

Advantages

h

Diagnostic management

The company will be able to move from a role of policy and benefits administrator to that of an active entity with the needs of the insured, where the safe handling of diagnostics will play a differentiating role.

 

Health pin

On the health platform, the insured will have the autonomy to carry out all procedures with the necessary identity validation. When necessary, the insured will use his or her health pin, for example, to give a doctor access to his or her health records.

Z

Mobility

In health insurance, iteractivity is high. It is therefore a priority to facilitate the tasks that the insured has to perform by means of a digital management model, which supports the activity at any time or place, with online systems, web, app and mobility.

i

Interactivity

Our solution records all interactions between the customer and the company and manages them through an intelligent system in order to improve service and gain efficiencies by better targeting spending.

l

Personal assistants

This personal assistant service is provided by software based on a knowledge graph and artificial intelligence techniques, including professional search or access to care provision.

Care chart

From its medical portal, providers and suppliers will be able to enrich their professional profile information in an agile and simple way, while the system allows intelligent searches of the professional by complex parameters.

s

Personal health history

The personal health record allows an automatic update of the information from the services provided by the contracted professionals. This allows the patient’s medical history to be automatically updated.

Self-management

Self-management facilitates access to patient services and allows the company not to employ talent in routine work. This is made possible by modular validation systems and information control.

k

Security

The health platform complies with the legal security requirements, but the insured person also has control over the processing of his or her data through the Health Security Pin and the synchronous authorisation of all services.

Applications

Health Insurance Companies that want to have a Core system for the complete management of their policies, with a differential focus on the management of benefits and the relationship between the insured, the service provider and the insurance company.

 

  • Dental Insurance Companies

  • Public Health System

Features

Digitized medical directory

Logical structuring system for care, providers, suppliers, providers, scales and services.

Online appointment

Linked and integrated with other modules such as video-consultation or care management.

Medical history

Always in strict compliance with privacy and data protection regulations.

Handling suppliers

Conflict and dispute resolution in settlement is addressed by implementing mapping and conciliation systems.

Collective management

The group management module adapts to the specific needs of any aggregation environment.

Bigdata analytics

La gestión de la información de toda la plataforma esta orientada a su integración y análisis.

Digital prescription

Automation and control of the generation of digital prescriptions and prescriptions. Repository management.

Video consultation

With access to medical records and easy management of prescriptions and related appointments.

Pricing and subscription

A product workshop has been added to enable the configuration of tariff calculations for health insurance.

Receipts and financial control

The concept of the management of receipts, collections and settlement with suppliers is developed to take it to a higher level.

Reimbursement of invoices

By means of a complete self-management system, without the need to provide original documentation.

Authorizing center

Workflow and self-management model with advanced charging in case of paid and co-pay services.

Delonia Magazine / Health Core