Smart Chip Card Solutions
part of AdvantageX Solutions

Development

Management

Testing

SCCS created advanced software solution aimed at insurance companies. Especially companies that insure health and life of their members. One of our recent customers turned their business towards more control and success, Sanlam Limited Insurance Group. Located in Kampala, Uganda they are specialized as health insurance providers.

Get to know

InsuranceX Main Software Modules

Members and doctors signup, protection plans

Signup is performed using WEB front end.
See features below ...

Medical institutions front end

Coming to the medical institutions and signing up is simple.
See features below ...

Digital billing

Doctor uses dedicated software module with simplified billing in mind.
See features below ...

Insurance agents login

Insurance agents and adjustors have to login using personalized smart cards.
See features below ...

Billing processing and payouts

Centre of the software is easy to view and use dashboard where all digital bills are listed.
See features below ...

Remote services and server

Main SQL DB is located in the remote server working 24/7 for doctors and insurance.
See features below ...

Make your call ...

Login choices

Choice is yours how will your insurance company handle members credentials and validation procedures

01.

Smart Card

Everybody gets issued a personalized smart card .
Learn More below...

02.

Biometrics only

Everybody uses just a biometrics, fingerprint.
Learn More below ...

Smart Insurance by smart cards

Is your company losing money to insurance fraud?
Regardless if insurance is small, big or even nation wide system, losing money to fraudulent claims should not be accepted and tolerated. Fraud is wide spread and makes everyone pay more for coverage. One of the most common practices is when person with insurance coverage shares his membership card with family members or friends.

We have a perfect solution for you! Smart insurance system called InsuranceX. Members get validated using smart cards. Biometrics is included!

Smart Insurance by biometrics

Instead of smart cards your insurance company may opt to use biometrics only for members validation. At a front desk they present a finger and get verified under one second.

This system may be appealing to your insurance company since there are no cards and person can't forget a credentials at home.

MEMBERS AND DOCTORS SIGNUP AND PROTECTION PLANS

MEMBERS - Member usually can sign up directly while interacting with insurance company agent. They can also sign up using dedicated WEB site front end. They create their accounts themselves thus relieving agents from that time consuming task. Records get written straight to the remote SQL DB.
DOCTORS - Doctors and medical institutions also use dedicated WEB site front end to enrol into the insurance system as a providers.
PHARMACY - If patient has to pickup medications in pharmacy it is again all digital and efficient procedure. Pharmacist dispenses medications and uses same billing module to send a bill to insurance. Insurance pays pharmacy using similar to doctors pre-approved price lists.
THERAPISTS - They are in the same group as doctors and appear as a medical service providers that are capable of sending digital bills to the insurance company.
LABS - Same as therapists, doctors and pharmacies. Independent labs are treated as a service providers and can send a digital bills.
PLANS - Insurance company can create unlimited number of protection plans. Each plan can be broken into sub services like: dental, labs, vision, therapy ... Each plan can be assigned to carry specific coverage amount. There is an automatic plan renewal, usually at the end of calendar year.

MEDICAL INSTITUTIONS FRONT END

PATIENT - Arriving into medical institution patient (subscriber) identifies himself using a smart card or finger. It can be both. It can be done at front desk or at the doctor's desk. Our software supports single ID verification point. Using optional picture in the card and biometrics makes 100% positive ID and system confirms eligibility of coverage.
DOCTOR - Knowing that patient's ID is confirmed and patient's insurance is valid doctor processes the patient. Provides medical advice, writes prescription, sends patient to labs or other specialists. Doctor uses dedicated software module to create a bill within one minute or less.
BILLING - After doctor is finished he can create a medical claim to bill insurance for his services. He uses already prepared ICDC10 international billing codes for precise and correct billing. Making bill and sending it takes less than 60 seconds. Doctor will get paid according to already pre-approved contract price lists.
PHARMACY - If patient has to pickup medications in pharmacy it is again all digital and efficient procedure. Pharmacist dispenses medications and uses same billing module to send a bill to insurance. Insurance pays pharmacy using similar to doctors pre-approved price lists.
SERVER - all bills get into AdvantageX - SCCS Cloud server. They are encrypted and protected against editing, copying, duplications or other changes. On the same server is also patient DB. Medical institutions DB. Doctors DB. Pharmacists DB and many other volumes of necessary data.

DIGITAL BILLING

BILLING - Billing is really heart of the system. Doctor will get paid according to already pre-approved contract price lists. Every procedure, every medication and every action by the medical professionals is included in extensive price lists.
SERVER - all bills get into SCCS Cloud server. They are encrypted and protected against editing, copying or other changes. On the same server is also patient DB. Medical institutions DB. Doctors DB. Pharmacists DB and many other volumes of necessary data. Insurance company has options to create unlimited price lists even that the most beneficial scenario is one single unified price list that is valid for all medical providers.
BILLS - Are fed into server and processed on server. They are stored indefinitely and are available for reporting.

INSURANCE AGENTS LOGIN

SAM SYSTEM - Security Access Module. There is a control sub system that controls access to the insurance system processing module. Its is strictly setup who can login and see what. System supports several levels of operators. On top of the login system is administrator. System supports unlimited agents. Every PC must have a smart card reader attached.
AGENTS - Every agent receives personalized smart card with written in credential needed for successful login. Smart card is inserted into smart card reader and when pulled out system shuts down software on that PC. After login agent or adjudicator is able to access dashboard and all other InsuranceX software modules allowed.
RULES - There are many rules involved to control access to the system. Rules control who can handle billing and adjudication process. For example rule does not allow adjudicator to process bills for the person with same last name. Also there is a rule that limits size of bill that agent can process. Higher amounts are processed by higher levels of agents.

BILLING PROCESSING AND PAYOUTS

BILLS - All bills arrive in electronic format into main server and are immediately available to insurance agents to process. They pop up on the dashboard. Those transactions are instant. If there is a sufficient number of adjudicators processing time could be scaled down to the same day or 2 days.
DOCTOR - Doctors have access to their part of DB to see own bills lined up for processing. E-mails or paper bills are matter of past.
PAYOUT - Payouts are done after bill is processed. System could be setup in such way that low amount bills could be processed automatically by the system. In that way things are sped up. Doctors get their money much faster and that is a bonus for them.
MONEY - Funds are sent by bank transfer directly to the doctor's account. Doctor or medical institution provides those details when signing up.
REPORTING - is bread and butter for any business, especially insurance one. Last but not a least is reporting software module. Out of myriad financial information gathered software produces valuable reports. Management can find out everything about company's financial health from dashboard and dedicated reports. It is invaluable tool for every manager. One has to be on top of the things and take corrective actions before profits get affected.

REMOTE SERVICES AND SERVER

SERVER - Server is heart of the system. In our case it is dedicated server with multicore processing, SSD drives, a lot of fast memory, smart card reader and other hardware to support fast and reliable operations. All bills get into SCCS Cloud server. They are encrypted and protected against editing, copying or other changes. On the same server is also patient DB. Medical institutions DB. Doctors DB. Pharmacists DB and many other volumes of necessary data.
LOCATION - Our server is located in Munich, Germany connected to fibre optic Internet feed.
WHY REMOTE LOCATION? - Before you get idea that server should be in the building next door, (wherever that may be) consider this. We have customer on St. Kitts island in Caribbean. One day an hurricane devastated island in such way that data centre was destroyed. Flood or electrical surge can do that. In that case remotely located server saved the day. No data loss occurred.
SECURITY - One of our customers experienced ransomware attack. All local servers were infected and rendered useless. Criminals wanted a lot of money in Bitcoin to provide (or not) a passwords to unlock encryption. Our customer chose not to pay. They reformatted all PCs and started from scratch, but all data were saved in SCCS server.
DISASTERS - Man made or acts of nature. Again hurricane comes to mind. September 2017. 3027 deaths. Electrical grid largely destroyed. Remote server allows coming back to use as soon as Internet is available.
HOW MUCH DOES IT COST? - Server monthly costs are approximately $500/€500. That includes backups, anti virus protection and regular maintenance.

The quality of the InsuranceX is assessed and proved

Software should meet its intended purpose
The software should be dependable and consistently perform
Performance assessment involves evaluating how efficiently the software operates
Usability assessment focuses on how easy it is for users to interact with the software

Send us a message

We look forward to your questions and requests

Zack P.

Sales manager

Smart Chip Card Solutions part of AdvantageX Solutions