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Konnect SureClaim automates medical claim requests, matching these to policy rules, and enables point-of-care electronic processing of payments direct from insurer to health provider.
Insurers can readily segment the claims workflow into simply approved claims and those requiring more detailed assessment.
For claims under a pre-determined threshold, where the patient meets the policy criteria, Konnect SureClaim uses a pre-approval capability to automatically process the payment from insurer to health provider. This reduces the administrative load of a large number of low-value claims which currently falls on the customer and the insurer.
For high value claims, Konnect SureClaim can facilitate a review of the claim against the medical information collected at point of underwriting.
| For the insurer | |
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A better customer experience and increased customer satisfaction through automated claiming and payment |
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Increased coverage of low-value claims with resulting improvements in customer loyalty |
| For the customer | |
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No need to claim back for costs |
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A system that automatically claims for all care covered by a customer’s policy, resulting in better value for their policy |
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No upfront expenditure for medical care covered by a customer’s policy |
| For the health provider | |
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Point-of-care electronic processing of payments direct from the insurer to health provider |
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Increased business referrals from health insurers |
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