Healthcare

Scenario: Healthcare Administration

Manual Process
Health care administration is the task of managing and maintaining the employee’s medical records. It involves maintenance of employees’ medical history. When an employee claims a medical expense, he produces the relevant hospital bills. HR records of the employee’s designation, previous claims and other information are checked and the medical claim is processed.

Issues
The health care administration is heavily dependent on HR records to process the medical claim. Changes in information such as the employee’s designation, dependents, and coverage make processing of medical claims slower. Processing is further prolonged because employees often forget to submit all documents required and the employees have to be contacted to submit the missing documents. The number of employees and their dependents has resulted in an accumulation of files. This makes retrieval of old files and medical case histories difficult.

Automation
Skelta workflows integrated with a document management system such as SharePoint can effectively streamline this function. Besides setting up workflows to expedite processing of claims, Skelta workflows can ensure that digital copies of claim forms, bills and records are automatically stored in the correct repository. Skelta workflow can also be automated to update employee records with claim amounts.

Skelta workflows can also provide an easy web-based interface for employees to submit their claims and check on the status of their claims. Skelta workflows can also be setup to initiate processing based on SMS requests or emails – an employee who is still in hospital can thus initiate a claim from the sick bed.