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.
The repayment cycle is reduced to 1/3 of the usual time
More than 85% of processes are automated
Manual labor is reduced to less than half
Input and encoding errors are less than 10% (fraud and abuse mitigation)
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.
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.
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.
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).
INTEROPERABILITY
Easy integration and communication with other management systems (eg ERP, Invoicing).
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.
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).
Descubra a solução mais competitiva e funcional do mercado, sem limite de utilizadores e sem renovações anuais
Quidgest is a global technology company headquartered in Lisbon and a pioneer in intelligent software modeling and generation. Through its unique generative AI platform, Genio, develops complex, urgent, and specific systems, ready to evolve continuously, flexible, and scalable for various technologies and platforms. Partners and large organizations such as governments, multinational companies, and global multilateral institutions use Quidgest’s solutions to achieve their digital strategies.
R. Viriato, 7
1050-233 Lisboa | Portugal
Tel. +351 213 870 563
quidgest@quidgest.com
