Health Management System (HMS)
The leading Health Management System in Zimbabwe
HMS is an end-to-end solution designed for the management and administration of health insurance or medical aid business processes.
Core Modules
Membership Management
Manages account profiles for medical aid members. Individual members are organised by company and each assigned a unique member number and suffixes for dependents. This module provides a detailed audit trail of all data modifications and has robust security features.
Benefits Administration
Each 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 facilitates keeping track of unused benefits and rolling over of these benefits at year end.
Billing and Subscriptions
Membership 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 Processing
MedExpress 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 a robust rules-based claims processing engine.
Technology
Microsoft .NET Framework 2.0, ASP.NET, VB.NET, SQL Server
Customer References
TN Medical & Dental Benefit Fund
TN Medical & Dental Benefit Fund, a subsidiary of TN Financial Holdings.
TN Zambia
Fidelity Life Medical Aid Society (FLIMAS)
Cell Medical Aid
Altfin Health Services
Blanket mine
