Health Insurance

Claims / Policy Automation / Leakage Control


JSure

Health Claims and PreAuthorisation Platform

Health Insurance Claims and PreAuthorisation management is a complex process. We have spent over hundred man years to perfect our solution for your needs.

JSure platform is a custom enterprise solution which works as a part of your core insurance system. 

Core Functions

  • Web based claims file entry

  • Approval Flows

  • Payments Management for Providers

  • Document Exchange with Health ProvidersIntegrations

  • Doctor, Speciality and Title  Catalog

  • Core Insurance Platforms

  • Pricing Integration with JMed 

  • Policy Rules Integration with JRules

  • Integration with UW Exemptions

  • Intgegration with Hospital Information Systems

  • Integration with Pharmacies Through JPharmacy


 

JSure

Fraud / Abuse Management / Analytics & Reporting


JBig Anomaly Detection

The first stage of fraud and abuse management is Anomaly Detection, because there are no ready data sets to leverage Machine Learning algorithms.

JBig Anomaly targets not only fraudulent activities but also ways to explore areas to help you with immediate financial gain, get more insight into product performance, increase your bargaining power with providers. Manage your claims teams and pre authorisation rules better by increasing automation levels even higher.

JBig Anomaly Detection

Underwriting Management and Policy Production


JDocs for Insurance and Policy Creation

JDocs for Health Insurance and Policy Creation

Paper forms, medical examinations and initial health insurance onboarding process requiring data entry for Insuring and Policy creation are simplified with JDocs.

Your applicants may fill the Smart Health Claim forms for entire family members via their smart phones. Smart forms have most valuable questions for time saving and optimize defined risk group questions.

Paper forms can also be imported with Smart Scan for detailed review by insurance brokers.

Undertaking process is simplified for collecting machine-based risk analysis, medical examination, external medical record research and sensitive data of other insurance companies.

Tracking service levels for onboarding will provide easily define and improve critical optimization points for best Customer experience.

JDocs for Insurance and Policy Creation

Better Customer Service


JSure Mobile PreAuthorisation

JSure Mobile Pre-Approval

JSure Mobile PreAuthorisation