360º HEALTH PLAN MANAGEMENT

A health plan software that offers 360º management is essential for organizations that invest in the health care of their employees and customers. Quidcare allows for greater global control and streamlining of all processes, maintaining the focus on providing excellent healthcare.

QUIDCARE – MANAGEMENT OF HEALTH PLANS IN NUMBERS

<1/3

The repayment cycle is reduced to 1/3 of the usual time

+85%

More than 85% of processes are automated

<1/2

Manual labor is reduced to less than half

<10%

Input and encoding errors are less than 10% (fraud and abuse mitigation)

QUIDCARE – STREAMLINES AND SIMPLIFIES PROCESSES IN THE HEALTH ECOSYSTEM

quidcare-360 health plan management system
    • Agility
    • Communication
    • Focus (health care)
    • Time
    • Manual Work
    • Errors
  • MANAGEMENT/BUSINESS

    • De-bureaucratization – paper-free
    • Profitability and efficiency
    • Speed and transparency of processes
    • Business automation and customization
    • Artificial Intelligence: reducing fraud and errors (risk mitigation)
    • KPIs – Profitability and process optimization
  • SYSTEM

    • Lifetime license system with unlimited users
    • Intuitive and practical system – all users
    • Evolutionary system – agile upgrades
    • Multi-level integration – interoperability
    • Accessibility and notifications – web portability

maior eficência na gestão dos planos de saúde

De-bureaucratization allows for streamlining and transparency of processes

Currently, ease of use and uncomplication are crucial aspects of services on all axis. Decreasing friction between what was ordered and the result is one of the key points that enables organizations to distance themselves from the competition and improve the efficiency of their operations.
The Quidcare Healthcare Plan Management solution allows for streamlining the revenue cycle through the automation of processes, reducing the burden of bureaucracy both for healthcare plan operators and for customers.
Real-time monitoring and consultation of the status of reimbursement and invoicing processes reinforce this entire process. As a result, the operator’s activity becomes more efficient, and customer satisfaction increases.

anti-fraude na gestão dos planos de saúde

Fraud/error processes are a huge impediment to the normal functioning of the revenue cycle

Although efficiency can be improved with a system that reduces response time – which, in turn, reduces costs – one of the main problems faced by operators remains: fraud.
In order to reduce the impact on the process, Quidcare presents an anti-fraud solution – driven by artificial intelligence – that searches for, identifies, blocks and notifies organizations in case of abuses, as well as errors associated with the entire process.
This is a truly troubling challenge in the operation of Health Insurance Management organizations. According to the National Health Care Anti-Fraud Association of the United States,3% of the country’s health budget is spent on fraudulent schemes. In Brazil, reports indicate that for every 100 reais spent, 15 correspond to some type of fraud.

humanização na utilização dos planos de saúde

Communication is a key point in the fluidity of the entire process

Although it is essential to use intelligent systems to facilitate processes, it is also essential that organizations humanize their operations – something that can be achieved through systems that facilitate communication between the end user and those responsible in Health Plan Operators.
The personalization of the experience through, for example, a portal where the patient can find all personal information, status of their processes and history, is a great asset. Quidcare is the ideal communication tool between organizations and users, where the human component has never been more important.

GUARANTEED BENEFITS FOR EXCELLENCE MANAGEMENT

Business Management

HOLISTIC MANAGEMENT

Centralized information, decision support and monitoring of the patient’s entire journey – from clinical management, through the submission of the request and the respective process, to feedback and the closing of the order cycle.

SPEEDNESS

It speeds up order processing by automating and streamlining processes – with the Health Plan Management system, the waiting time for processing reimbursement and payment processes is now 1/3 of the usual time.

CUSTOMIZATION

A solution adapted to any business model. Flexibility and easy parameterization of process business rules (limits, incompatibilities, ceilings, and prior authorizations).

interoperabilidade do gestor de planos de saúde

INTEROPERABILITY

Easy integration and communication with other management systems (eg ERP, Invoicing).

Financial Management

ANTI FRAUD

Artificial intelligence mechanisms that improve the detection of fraud and errors, reducing an important vanishing point in the process.

PRECISION

Greater control and precision in the global management of processes and costs (360º).

DECREASE IN COSTS

Quidcare increases the productivity and efficiency of the resources involved, in less time and with greater precision, thus reducing costs.

DASHBOARDS/REPORTS

Performance metrics and analysis allow you to streamline and review processes, identify breakout points and problems, allowing for a quick resolution.

Stakeholders

HEALTH PLAN OPERATOR

Decrease in the time of procedures, automation of processes, decrease in errors and fraud, decrease in costs, and access to indicators for improving business processes.

BENEFICIARY

A faster and more transparent reimbursement process allows for a greater focus on your healthcare.

DOCTOR

You waste less time on bureaucracy – more attention to the patient.

HUMANIZATION

Quidcare facilitates access to information and communication between different users (patients, health professionals, and health plan operators).

CUSTOMERS THAT MANAGE THEIR HEALTH PLANS THROUGH QUIDCARE

     

Descubra a solução mais competitiva e funcional do mercado, sem limite de utilizadores e sem renovações anuais

ABOUT

Quidgest is a global technology company, a pioneer in automatic software modeling and generation. Through the extreme low-code platform Genio presents a vast portfolio of solutions, in different areas, aimed at continuous improvement in the management of companies and public institutions of excellence.

a Quidgest é uma empresa certifiicada

CONTACTS

R. Viriato, 7
1050-233 Lisboa | Portugal
Tel. +351 213 870 563
quidgest@quidgest.com