COMPANY PROFILE Contact Details

Transcription

1 Company's Name: Software's Name: E-Meditek Technologies Pvt Ltd E-M Previous RFI ITEMS CHOICE LISTS FREE ANSWERS / DESCRIPTIONS / COMMENTS Contact information of the person who fills the questionnaire: Name Gopal Verma Position MD address vermag@emeditek.com Phone number Since when are you working with this institution? Since Inception COMPANY PROFILE Contact Details URL Postal address emeditek.com G VIHAR, PHASE V, GURGAON, HARYANA Country INDIA Region South_Asia Fax number Sales representative Technical manager Established since 2003 Status Incorporated Staff 100 Whole company staff 800 Core Insurance / health insurance Systems Staff 500 Sales & marketing staff 50 Implementation & training staff 25 Technical support staff 20 Product development staff 15 Management & administration staff 5

2 Other Other software systems / services that your company provides HealthCare Management Softare, Insurance UnderWriting and Claims processing Software Systems Services e solution related to Health care and Insurance Has your company set up partnerships for the healthinsurance market? with health insurance Institutions? no with Resellers? with Consulting companies? with NGO's? with other type of institutions? Main evolutions since 3 years althcare and Insurance pro State of the Art Halthcare and Insurance product development Trends for next 3 years SOFTWARE OVERVIEW E-M Software versions Date of 1st release 1-aug-10 Number of releases 4 Latest version number 1,4 Number of installations latest version 3 Number of installations previous version 0 Date of last released version 31-dec-12 Type of institutions targeted Commercial Insurers Hospitals Non-profit Organizations Others Market references 5 Number of operating clients in 2010/2011/2012 Lowest and highest number of branches within health insurance clients 10 and clients as of now and 1.2 million lives average per year

3 Average number of branches per client Lowest and highest nb of accounts handled within clients Number of health insurance clients by country (2011) 6 million lives Number of ongoing installations by country 3 Number of clients in 2010/2011/2012 by type Commercial_Insurers 26 Hospitals 4000 Non-profit Organizations 0 Other 0 Commercial offices (including resellers) Number of commercial offices 0 Location of commercial offices 0 Support center (including resellers) 0 Number of support centers 0 Location of support centers INDIA Support center staff (number of people) 10 Hotline Support in which languages Technical documentation available User documentation available User club existence Main evolutions since 3 years Trends for next 3 years Forecast features under development for the software by ENGLISH World Class Datacenter, Datacenter & Server Virtualisation, Infrastructure High Avalability & Maximum Up time By DR/BCP with Latest Technologies, DMS, FAX INNTIGRATION, PAPERLESS CLAIMS PROCESSING COMPLETE PAPERLESS ENVORONMENT, SMARTCARD BASE HEALTH CAR

4 Further innovation in pipeline for health insurance market Outsourcing Targeted new clients for next 3 years According to you, who are your (3 main) competitors as health insurance software editor? Current competitors Estimated future competitors The five major strengths of your software Flexibility Consolidation / Possible network configurations Single PC Decentralised Decentralised with consolidation tool Centralised on line Centralised on line with off-line option Other Technical Deployement of software Stand-alone Client/Server ASP Web Interface Multi-Tier Delayed posting Tracking flexibility Tracks clients at different levels (individual, group, village, branch, region, institution Track current and historical client portfolio of loan officer / supervisor Multiple branches or regions Mechanisms for separating information on an office basis Presentation of financial or statistical information by branch or region Ability to neutralize inter-branches transactions All Insurance Companies related to Group, Retail & Micro CMC-CSC CMC-CSC Table Driven, Inbuilt Capability of DMS, BPM & Data within Single Interface, Comprehensive, Felxible,Expandable, Configurable, Based on Advance Technology,

5 Multi institutions Maximum number of accounts handled by software Maintenance of indicator lists for selected data (like region list) Is there any field that can be modified or added by user? Multiple languages Technical documentation and user guides languages ENGLISH Languages available within software ENGLISH Can support languages on a user basis All messages are in the language of choice All screen information is presented in language of choice Multiple language support requires recoding (language is hardcode) or is intrinsic to the system (language is parameterized) Statements can be in different languages? If yes, possibility to allocate a language to a client? Ability to handle non roman scripts Multiple currencies Supports local currencies and foreign currencies Supports loan / deposits accounts and teller transactions in different currencies Supports foreign exchange exposure calculation facilities Handles maintenance of value accounts and other inflationary risk mitigation functions Possibility to add a currency Rounding Rounding per currency to fit cash constraints (5, 10, 50, 100, ), possibility to set it up by product Rounding of installment amounts (Principal + interests) Provision Calculation set by ageing rules and product type Calculation modes (total outstanding, past dues only,...) Provision automatically calculated at disbursement FUNCTIONAL COVERAGE Beneficiary Management Enroll beneficiary or insured Demographics

6 Financial information Geographic information Qualifying criteria (see qualifying conditions) Proof of identity (e.g. national identification card, personal identification number, biometric information, photos) Medical history Current medical condition Assign insured to a PCP or primary care unit insured identifier Census Benefit class Benefit plan Physical proximity (e.g. work or home) List of available providers Family relationships Maximum number of insured to which a provider can attend Eligibility inquiry by provider Benefits class Benefit plan Encounter date Insured accumulator Demographic criteria Clinical criteria Eligibility inquiry by insured Benefits class Benefit plan Date of inquiry Demographic criteria (CARD ) (NSP CODE)

7 Pre-authorization Benefits class Benefit plan Clinical information Supporting documents Treatment plan Fee schedule Diagnosis Provider Management Register/empanel provider Provider license Physical proximity Qualifying criteria Maximum number of insured to which a provider can attend (i.e., level of services available based on staff) Provider type (doctor, hospital, health center, pharmacist, etc.) Provider banking information (e-payment) criteria, provider sellection takes place and after signing SLA, provider brough into Provider agreement Privacy restrictions Fee schedule Previous agreement/ contract agreement template Region of the provider (there may be rural differentials in the fee schedule) Specialty of the provider (there may be a difference in fee amount based on the specialty) Premium collection Premium collection Premium is collected on quaterly basis from underwriting offes across country.

8 List of insured Sponsor classification (i.e., company, government) Benefit class Premium rate Payment status (arrears, current) Eligibility status Claims Management Claims Processing Claim Adjustments Voids Benefit plan Re-submitted claims Claims-related policies Pre- authorization match Eligibility status Benefit class Insured accumulators Co-insurance Claims are registerd into the system from all over the branches and they process the claims in their respective region. Being claims document as digitally stored withing the system under DMS process, claim can be handled by any user sitting on processing terminal across country. LTILEVEL APPROVAL, AUDIT, FRAUD CONTROL

9 Copayments Deductibles Fee schedule Provider accumulators Claims Status inquiry Claim identifier UNIQUE CLAIM NUMBER CARD NSP CODE Encounter date INTIMATION DATE Claims dispute and appeals Claim identifier CLAIM INS CODE NSP CODE Claim information INTIMATION (e.g., encounter date, claim number) Dispute notes FREE TEXT Claims adjustment and voids Claim identifier CLAIM INS CODE NSP CODE Claim information INTIMATION (Encounter date, claim number)? Claim adjustment amount? Increase of claim payout? Decrease of claim payout? Void Accounting Payment to providers NSP CODE WITH Bank Detail Financial transactions from accounts payable and receivable GL (approved claim, adjusted claim, void claim) Capitation list

10 Summary of current outstanding premiums Summary of premium amounts received to date Summary of subsidy received from national/regional government agencies Summary of subsidy to be received Interest from investments Accounts receivable Summary of current outstanding premiums Summary of premium amounts received to date Summary of subsidy received from national/regional government agencies Summary of subsidy to be received Interest from investments FROM ENROLMENT DATA Accounts payable Summary of provider payments paid to date Standard business operations (non-claim related) (e.g., utilities, consulting services, vendors) Premium refunds Miscellaneous claims (e.g., those lost on appeal) Reporting Existing operational reports SQL QUERY Existing financial reports SQL QUERY Existing management reports SQL QUERY Regulatory authority reporting (Central Bank) configurable SQL QUERY Microinsurance Key Performance Indicators SQL QUERY User defined reports SQL QUERY Possibility to perform trend analysis / comparisons (i.e. this month vs last month, payment performance analysis...) SQL QUERY Export utility (Word, Excel, other format, ) SQL QUERY Customized statistics SQL QUERY Additional functionalities Payment cards core banking system Check management Payment services (bills, utility management) Money exchange service core banking system core banking system core banking system

11 Credit scoring Customer relationship management HR administration Batch transfer functionality Other products and services EASE OF CONFIGURATION Configurator exists Parameterization steps Calendar (holidays / working days) Configuration printing Configuration interface/ergonomy core banking system core banking system additional module core banking system additional module Possibility to replicate the configuration from one system to another SECURITY Audit Audit methodology Unique teller identification number Traceability of products parametrization Traceability of connections - loggings Traceability of transactions Identification Users profiles (roles and privileges) Activate / deactivate a user Technology used Accountability by transaction by consultation data collected in log file Backup management Using an external tool Internal tool: specify whether manual or automatic AUTOMATIC Automatic recovery tool AUTOMATIC

12 Data protection on database between remote stations on external floppies and backup cartridges LTO 4 TECHNICAL ARCHITECTURE Server requirements Operating system Minimal configuration for , , clients Optimal configuration for , , clients Size of server application for , , clients Windows Bit Standard Edition Dual Xeon Quad Core 3.0 Ghz, 4 GB RAM, 2 * 300 GB HDD with RAID1 Database Server (Recommended IBM X3400) Dual Xeon Quad Core 3.0 Ghz, 8 GB RAM, 2 * 300 GB HDD with RAID1 Application Server with DMS (Recommended IBM X3400) Dual Xeon Hexa Core 3.0 Ghz, 16 GB RAM, 2 * 300 GB HDD with RAID1 Database Server (Recommended IBM X3650M4) Dual Xeon Hexa Core 3.0 Ghz, 32 GB RAM, 3 * 600 GB HDD with RAID5 Application Server with DMS (Recommended IBM X3650M4) Network requirements Describe the usual configuration N/WAN) with Minimum configuration of Layer2+ Switch Protocol Internet TCP/IP Database requirements Server 2008/12 (64bit) Standard Edition Supported native databases ODBC, JDBC ODBC Workstation

13 Operating system Supports Microsoft Windows XP above, Linux Ubuntu with Internet Explorer 6 above, Mozila Firefox or Google Chrome Brwoser Minimal configuration Processor, 512 MB RAM, 80 GB HDD Optimal configuration Processor, 2 GB RAM, 250 HDD Size of client application olution So no Space required at Client side Existing interface Excel, Word, text formats (TXT, CSV) Other Software Programming language SQL 2008 and Dot Net 4.0 Open source Other integrated tools FAX VIEWER PLANNING, TRAINING AND BUDGET System implementation Implementation methodology Describe how you build capacity at your client to replicate implementation N POSSIBLE AND DATA WILL BE TAGGED WITH THAT BRANCH of one branch to other branches by itself Installation & training partners (please indicate installation and training ENGLISH languages where appropriate) Average implementation time (from contract signature to service launch) Quickest implementation Longest implementation Guarantee period Installation CD ROM available Software update procedure Training User training If yes, how long? Who? Cost System administrator training If yes, how long? Who? Cost 15 Day 7 Day 6 Months On Line nt material and online training material E-Meditek, Free (included in pricing)

14 Training local IT specialist If yes, how long? Who? Cost Cost of programmer man-days for customization System pricing License (basis, range cost) License expiry Annual maintenance fee (basis, range, % license) Cost per transaction (basis, range) Assistance included in the initial license cost 20 USD per hour nterprise License 200k USD 20% of base price sactions range can be from 1 usd to 10 usd Average cost of installation, with standard training included (% license) + Travelling +Hotel Exp + Perdiem Additional modules (not included in the standard software) - List features COMMENTS, TES Questions Comments NA