This module manages the medical and insurance claims presented by the employee on his/her behalf or that of his/her dependents. This module provides the means of defining medical care agencies that include: hospitals, physicians, specialists, physiotherapists, pharmacies, medical laboratories and others as well as defining the services offered by each using a standard pre-defined list of services. It allows identifying whether the medical care agency is affiliated with the company and the syndicates. It also helps managing the processing, filing and tracking of the employee claims whether on his/her behalf or on that of their dependents with the concerned organizations such as the National Social Security Fund or private insurance companies. It calculates the financial contribution of each party depending on the rendered services.

Key Features:

• Manage claims related to work accidents and others
• Keep proper log on various contributions, disbursement of each party
• Reconcile payment with the National Social Security Fund
• Reconcile payments with the various medical care agencies
• Provide the possibility of customizing the interface with the Information System used by the insurance company
• Track health records for employees and their dependents
• Prevent duplicate claims and eliminates error and fraud
• Provide statistical data and control reports based on various entities: beneficiary (employee dependents), employee, hospitals, clinics, physicians, pharmacies, etc.