HEALTHCARE BENEFITS MANAGEMENT

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Subtitle:

Healthcare Benefits Management

abstract:

GlobeMed offers franchisees the tools and expertise

GlobeMed offers franchisees the tools and expertise to fully manage their network of healthcare providers and administer health insurance claims from pre-certification of admissions and service provision to case management, claims adjudication and payment settlement. The process is facilitated by an e-claims portal available to GlobeMed’s healthcare providers’ networks, allowing them to manage approvals and process claims supported by a 24/7 call center. In addition, our franchising model gives franchisees access to the following services:

• Benefits administration and members’ enrolment services, including the definition of benefits and restrictions, technical and medical underwriting automation and rules, card issuing, policy management and policy owner services.

• Reporting services and business intelligence capabilities to provide business analysis and performance monitoring.

• Special customer service tools, including specialized call centers such as a policy and network information desk, complaint desk and IT helpdesk.

download our brochure:

gm_hbms.pdf

OUT-PATIENT BENEFITS MANAGEMENT (OBM)

GlobeMed’s Out-Patient Benefits Management (OBM) solution combines a state-of-the-art IT platform, industry know-how and best practices to effectively manage payers’ out-patient benefits plans and improve members’ experience, while controlling costs.

PORTAL PER POSITION

The Portal per Position Project is about managing workstation processes based on a set of parameters that include the job function, position, department & type of organization.

PUMA (Production Underwriting Monitoring Analysis)

GlobeMed innovative web-based solution PUMA comprises 5 modules:

HEALTHCARE BENEFITS MANAGEMENT

GlobeMed offers franchisees the tools and expertise

PHARMACY BENEFITS MANAGEMENT

The standalone Pharmacy Benefits Management (PBM) solution built by GlobeMed is a core set of tools designed to manage the cost and use of prescription drugs

CODING TRAINING PROGRAM

PHARMACY MANAGEMENT SYSTEM

Pharmacy management systems help pharmacies streamline their workflow thus delivering better care through a more efficient, automated process...

MANAGEMENT OF PRIMARY AND DENTAL CARE CLINICS

Recognizing the importance of primary care in improving health outcomes and managing costs...