Universal Healthcare System
In the Government segment we are working with the State of West Bengal on its Universal Healthcare Scheme - 'Swasthya Sathi' wherein we have over 24 million families on the platform. All the stakeholders use our application to transact on this program via various methodologies including, WhatsApp, mobile apps, call centres and Twitter.
This program is administered through a paperless IT ecosystem which consists of a dedicated centralised database and a single window online system for various business processes. These processes range from collection, verification, and finalisation of data to enrolment of beneficiaries. Issuance of smart cards, empanelment of hospitals, claim management and reporting are also carried out with the help of this online system.
Some of the key highlights of Track Four solution:
- Geared up to connect digital tools to input patient unique identification and confirm their enrolment under the same.
- The system efficiently identifies and validates each beneficiary at the time of claim intimation.
- Platform is seamlessly connected with hospital for real time data transfer in case of cashless claims.
- The system has been implemented with fraud control mechanism with features like 3 step verification by ISA, by doctors of H&FW and medical audit team. Real time SMS triggers in registered mobile numbers during any transaction, CSN mapping to prevent any impersonation/card cloning & many more
- Grievance management mechanism with features like call-based feedback mechanism for the patients for reporting inconsistencies in the process & Front-end tool for providers and insurers to register and track complaints and provide feedback for their experience
- Dashboards & Analytics using Business Intelligence (BI) Tools taking out critical reports on admission wise, age wise, geographical reports, health wise reports, transaction reports and many more.
