GET Medical Claims Management automates the process of healthcare related benefits and claims management, through a reliable and secure platform that connects insurance payers, health providers and patients.

The solution reduces operational costs, speeds up the claims process, detects fraud or abuse of insurance services, and maintains historical data while ensuring security and compliance with local regulators and international standards.

Provider Application

• Replaces the old manual process of creating, submitting and processing claims
• Automation of the processes ensures cost saving and enhancement of employees’ efficiency
• Independent of the provider infrastructure

Payer Application

• Covers all stages of the claims processing cycle from receiving the e-claims to giving approvals and up to settling of payments
• A configurable fraud detection algorithm detects fraud cases and stops them before they occur

Patient Application

• A specialized mobile application for participants to access on the go
• Easy and clear preapprovals and reimbursements’ submissions through the system
• Instant access to patients’ stored vital data
• Faster reimbursement process

Provided with the right infrastructure, the system scalability allows it to connect an insurance company with its network of providers, or a third party administrator serving multiple insurance companies with its network of providers.

The system can be implemented at a nationwide level, thus becoming a hub that connects all insurance companies and third party administrators to their respective network providers.

Insurance Companies

• Connect insurance company with its providers network and participants
• Automate the benefits plans management, the claims adjudication process, and the remittance

3rd Party Administrators

• Connect the third party administrator with its list of clients, providers network and participants
• Automate the claims adjudication process, and the remittance

Nationwide

• A central hub connecting all payers (insurance companies and third party administrators) with their respective providers network and participants
• Regulates the flow of information between all parties
• Automate the benefits plans management, the claims adjudication process, and the remittance