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Smart Insurance

Smart Insurance

Employees are valuable assets for every company to achieve company goals. Employee productivity can be disrupted if their welfare is not met. are you providing optimal protection benefits for your employees?

AFYA-IGS OVERVIEW

  • Covers group life and health products
  • Product Setup
  • Product management and customization
  • Benefit
  • Premium Setup
  • Custom plan with Family Limit
  • Administrative service only (ASO)
  • Term & Condition
  • Profit Sharing
  • Reinsurance
  • Policy Holder
  • Proposal 
  • Underwriting
  • Policy setup
  • Policy document
  • Membership
  • Member addition / alteration / deletion with upload function

Alternation of :

      • Product
      • Plan
      • Limit amount
  • Termination / deletion with premium refund
  • Membership certificate
  • Renewal
  • Pre-renewal process
  • Billing Premium
  • Create billing (new business, renewal, movement)
  • Billing notification
  • Additional billing (letter, invoice, report)
  • Billing correction and adjustment
  • Collection of billing premium from policy holder and member.
  • Sales management
    • Agency, broker, referral
    • Commission setup
  • Commission calculation
  • Commission aggregation
  • Commission adjustment
  • Commission payment
  • Commission refund
  • Policy owner service (POS) modules
  • Integration to agency system
  • Integration to TPA systems (member from enrollment) and accounting / finance system using file / API
  • Reports, letters, and dashboard
  • Claim (next project)
  • Cashless
  • Membership data
  • Claim verification
  • Excess claim management
  • Reporting to TPA
  • Claim list
  • Claim payment
  • TAT
  • Internal claim checking and validation process
  • Claim payment
  • Reimburse
  • COB (BPJS & Other insurance)
  • Provider management
  • Term and condition
  • Hospital discount

Reasons Switching to AFYA-IGS

  • More than 10 years experience in healthcare industry.
  • Existing systems do not guarantee that all the necessary information is available when and where it is needed.
  • Existing systems are difficult or not integrated so that with many logins and different interfaces, it burdens the users who use them, as well as patients.
  • Existing systems hinder the ability of insurance to measure outcomes effectively and implement standardized process, which in turn slows revenue growth.
  • Availability of a dedicated and comprehensive online training module using the proven open Learning Management System, namely edX. This online training has been divided into roles and modules, making it easy to use.

Group System Functional Diagram

Reason switching to AFYA INSURANCE

  • Software empowered business.
  • To avoid any Fraud, Waste and Abuse in medical treatment.
  • No mapping & grouping error of the itemized claim data made by provider.
  • Fast claim system verification.
  • Big data is available whenever is needed.

AFYA-IGS Architecture and Technical Spesification

Platform: Java based, using Spring Boot 2.6.7, which can be deployed on premise or cloud

Application Server: Tomcat 8.5

Framework: Spring Boot

Database: Oracle 11

Development tools: IntelliJ

User interface: HTML, CSS, JavaScript, AJAX, jQuery

API: RESTful Web API

Operating System: Linux / Windows

Server: REHL 8 / Ubuntu 13 / Microsoft Windows Server 2019

Client: Windows 10 / 11 / Linux

Please contact us at the following contact

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Our Valuable Clients

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PT. Daya Indosa Pratama (DIP) is an IT company which provides both products and solutions in the field of Healthcare and Education.

Jakartas

JL. Angkasa Blok B-16 Kav. 4 Gunung Sahari Selatan, Kemayoran Jakarta Pusat 10720 Phone : (021) 2236 1115

Bandung

Jl. Tubagus Ismail XV No 19, Bandung 40134 Indonesia
Phone : (022) 2503616 Fax : (022) 2501673