Revolutionising the processing of medical aid claims to drive customer loyalty and engender trust

A leading South African medical aid insurer trusted BSG to implement a large-scale, high-risk and complex system replacement; allowing for innovation and flexibility while ensuring existing, daily business operations weren’t impacted.

overview
  • Ability to pay as per authorisation for a medical treatment
  • Build trust with customers to drive loyalty
  • Replace the 20-year old legacy system
  • Adopt and administer new medical aid schemes through a configurable set of administrative rules to ensure transparency and manage risk
  • Limit IT dependency by enabling business to update and configure the new system without involving system teams
  • Enable strategic growth through new architecture for the business domain
objectives

Develop a highly configurable claims processing and benefit authorisation and management system to support the insurer’s long-term strategic vision:

  • Define a simplified and scalable new system design
  • Ensure a flexible and configurable platform for quick changes with full predictability of the impact and outcome
  • Support end-to-end process integration, maximum automation, precision execution and operational excellence
  • Ensure full traceability of all transactions and outcomes, simulation ability and multi-dimensional view of data to enable advanced risk management and better product design
benefits
  • Better managed and more seamless application process for authorisations and claims
  • Enhanced customer experience through smoother operating processes and quicker access to additional innovative products
  • Faster release of new products and enhancements to meet customer requirements through reduced implementation cycles
  • Improved user interface (UI), integration points and interfaces with external systems, with optimised internal databases
medical-insurance-medical-aid-claims-loyalty-bsg_overview

Integrating claims and authorisations to allow the flexibility needed for quicker reaction to market changes and customer requirements and demands.

Do you have a legacy system that needs upgrading?

Our Business Consultants and Software Developers have the necessary skills to evaluate your needs, and design and implement a core system to replace your legacy system.

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