HMS is a web based medical aid management and administration software developed for local clients to administer health care funds. It is an end-to-end solution which manages all the activities during entire medical claims processing.
HMS’ unique pricing and licensing structure meets your unique needs.
Membership ManagementManages basic personal profiles of all members and Medical Aid account holders. Individual members are organised by company and each assigned unique member numbers and suffixes. This module provides a detailed audit trail of all data modifications and has robust security features.
Benefits AdministrationEach member of the fund is assigned a set of benefits, each with a limit from which they draw each time they submit a claim. The module keeps track of unused benefits and rolls over of these benefits at year end.
Billing and SubscriptionsMembership in medical aid societies is on an annual basis with monthly subscription billing cycles. This module handles receipt of funds and invoicing of clients/customers for the medical aid benefit offered by the society.
Claims ProcessingHMS allows capturing of medial aid claims forms, validation of these claims to check for consistency and to mitigate fraud, and processing payments for medical service providers (doctors, clinics, hospitals, pharmacies, etc). This module boasts of a robust rules-based claims processing engine.
Other Features in HMS2007 Campaign ManagerCommunication in HMS2007 is highly facilitated by Campaign Manager. This is a specialised feature in HMS that allows for automatic e-mailing and faxing of invoices, statements, letters etc to clients. SMS’s can also be sent to clients through campaign manager.
ReportsHMS2007 integrates with Crystal reports, a world class report writer; allowing customization and addition of reports to suit your requirements..
Compatibility with other Systems HMS2007’s architecture allows it to be highly interactive with a lot of other systems like Pastel, QuickBooks, and Asset Management Systems just to name a few.
