Simétrica Suppliers Functionality, Components and Services

As part of the needs of a company that provides health services, both medical and nonmedical (laboratories, hospitals, clinics) there is the process to make your medical clearances and laboratory studies, so you can stay online or automatically and always be done with the same information, avoiding the differences in services and authorized amounts at the time of obtaining payment of the claims made to the health administrators.
On the other hand, the Inssurance Health Companies, have the needs to speed up the process of authorization and the claims of the services providers in order to achieve by this manner to reduce the time and manual processes performed by the staff of the Inssurance Health Companies to make payments of claims received.
Furthermore, the use of IVR (Interactive Voice Response) by service providers is also high risk for health administrators and although it has come to speed up response times, has not managed to avoid differences the amounts authorized and paid.
In addition, for suppliers is of vital importance to improve customer service times at the moment of consultation for medical authorizations and thus unify the process of authorization, with the possibility of making more specific checks of members through identification (identity card, passport, name) and affiliate code.


Fundamental Characterístics

  • Suppier integration with Inssurance Health Companies
  • Online access to the same information
  • Reliable and accurate verification of the Affiliate
  • Improve Times Customer Services
  • Authorization Process Unification
  • Catalog Coverage Availability of the integration with Inssurance Health Companies
  • Automatic Claims Conciliation Process
  • Obtained authorizations reports for claims support
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