The digitisation process at statutory health insurance companies

In order to remain competitive, it will be necessary to keep process costs at a minimum and to relieve staff from as many routine tasks as possible. An exceptionally service-oriented mentality will also be required.

A digitisation strategy for this sector will therefore require the successful implementation of several aspects:

• The use of black box processing, which allows the numerous and complex processes to be undertaken automatically and without any manual intervention.
• The comprehensive optimisation of the specialist processes must be viewed as a whole, from the beginning to the end, and continuity of media and change of jurisdiction must also be considered.
• All of the operational tasks are performed efficiently and effectively, thus creating a modern, client-friendly health insurance management system.
• Individualised process solutions are implemented

As well as having expert knowledge of health insurance processes, we also have many years of industry experience in the area of developing and integrating large core systems – particularly in the health sector. This combination is what makes adesso such a strong partner. From selecting appropriate processes and creating functional specifications, right through to implementing your processes – with us at your side, you will overcome the challenges of process automation and your business will remain competitive.

In light of the ever-growing competition and in response to well-founded analysis and decisions, it is necessary for statutory health insurance companies to respond flexibly to changing market conditions. To do so, obtaining information and data is just as crucial as having a streamlined, straightforward way of making this data available. In this context, business intelligence (BI) solutions facilitate a flow of information via a single media channel, which therefore paves the way for data and knowledge to be managed efficiently.

adesso offers reliable techniques and methods for the optimisation of process chains. It does so by using cutting-edge technology – including the forward-looking analysis of your processes and the implementation of intelligent data warehouse solutions – to make lasting improvements to the flow of information and to knowledge sharing. Our BI solutions support the whole process, which ranges from acquiring the data and converting it into information, right through to issuing valuable knowledge that is used to steer critical business processes and customer-oriented services in the right direction.

Whether you need us to design a BI strategy, develop an ETL process or compile an expert report, you can benefit from our numerous years of industry experience and our expertise in a wide range of technologies (Microsoft, SAS, IBM, QlikTech).

The competition among statutory health insurance companies means it is imperative that all processes run smoothly. Furthermore, there should not be any large unpaid balances and expenditure for services should be avoided. Have you recognised the need for action yet? Are you planning to revise existing systems or introduce a new system?

As an expert consultant, adesso can provide you with practical support by offering process consultancy for the following areas:

• Services (hospital/rehabilitation, psychotherapy treatments, incapacity for work)
• Notifications/contributions/finances (monthly billing, morbidity-oriented risk structure compensation)
• Sales/CRM/partners (task management, partner management)
• Care management
• Our industry expertise is brought to you by specialised social insurance professionals who have the necessary methodological skills.

In addition to our methodological expertise in the area of process management, we are also extremely knowledgeable about the technology involved. We are therefore exceptionally well-placed to support you with your proposed projects, from the requirements engineering phase through to implementation.

In order to make the most of synergies when health insurance companies undergo full legal mergers, it is necessary to create one shared database from each relevant insurance company’s existing database. Merging the existing companies involves consolidating all of the relevant existing data from two health insurance companies on one appointed date.

Numerous mergers may become necessary and the need for a merger may arise at various times. It is therefore imperative that an amalgamation is possible at any point in time. The potential for mergers results in stringent requirements regarding the maintainability and expandability of software.

Furthermore, we advise you as you formulate strategies for amalgamating your core systems. Within the scope of our consultancy services, we also provide you with practical support for upcoming merger projects. If entirely new merger systems become necessary, we will develop these systems or use the underlying technologies as a basis for building a complete merger software solution.

We have numerous years of industry experience in the area of developing large core systems for statutory health insurance providers. This means we are very familiar with the requirements that are associated with a merger.

Acquiring customers via external sales partners is a route that health insurance companies can pursue in order to generate business from new customers. Nevertheless, the following aspects should be considered in relation to acquiring new customers:

• In order to minimise the amount of acquisition work required, the sales partner process should be fully automated. Including plausibility checks in the automated process makes it possible to improve the quality of the data.
• The broker must be provided with a final product that has a transparent process. It is important that aspects such as the processing status are quick and easy to view. The relevant new customer acquisition statistics should also be made available.
• The analysis and management options in the customer acquisition process should be designed in such a way as to be simple and efficient to use. You are therefore provided with a straightforward way of managing aspects such as sales-related analysis, role-based permissions concepts and access statistics.

Ensuring that the solution is easy to use and has a user-friendly interface are aspects that should remain a high priority. We offer health insurance companies and their sales partners an opportunity to manage their communications and to process new applications in a simple and efficient way. We partner closely with many health insurance companies, which means we are very familiar with the existing systems used by statutory health insurance companies. We also have in-depth expert knowledge of health insurance processes. This enables us to offer you a high-performance, dependable solution.

In order for health insurance companies to remain competitive, it is crucial that they have a professional, feature-rich Internet presence and a lasting, functional information processing system.

A modern online portal is a way of guaranteeing higher levels of customer satisfaction, which in turn improves customer retention. In keeping with this, your Internet presence must be well-structured, personalised and user-friendly so that customers can quickly and easily complete the task they aimed to do.

For internal purposes, there is an increase in demand for intranet solutions, which are an integral feature of modern, digital workplaces. They are an excellent way of providing your employees with information and they offer collaboration features.

We can support you by providing industry-specific expertise in the area of enterprise content management technology and we can develop customised solutions that facilitate the introduction and integration of company portals. In order to bolster your online presence, we help you to design a suitable app – perhaps for use in advice sessions during the sales process or for providing information about insurance policies or special offers (in the area of bonus management, for instance) – and we develop the app for you.