backgroundYour Vision a RealityYour Vision a RealityYour Vision a Reality Slide ETPA Core Engine mobile application business intelligence Slide underwriting medical network medical rules engine approvals claims chronic finance customer service Put in place an Abuse and Fraud Firewall; Ensure accurate and timely approvals decisions. Online Approvals & Pre-Authorizations Multiple Approval Request Channels Provider Web Portal Client Web Portal Mobile Application Email Integration Offline Automatic Approval Decision based on Automatic Insured Eligibility Check Automatic Policy Configuration Check Automatic Medical Rules Validation Automatic Non-medical Approval Engine Rules Verification Policy Related Rules Insured Related Rules Benefit Related Rules Provider Related Rules Fraud and Abuse Pattern Detection Fast Access to Insured Medical File Medical Conditions Services Timeline (Diagnostics, Treatment, Hospitalization) Episodes Related to Medical Conditions Dispensed Drugs Timeline by Type and Main Ingredients Multiple Approval Request Channels Fast Access to Insured Timeline Aggregated Transactions Detailed Transactions Insured and Provider Notification (SMS & Mobile App)
