A new series featuring promising product or service innovations in global health

When it comes to healthcare, Nigeria is faced with several challenges. These include everything from lack of adequate technology infrastructure and high operational costs to the manual submission and processing of health claims. Simply put, Health Insurers and Providers don’t have the capacity to manage the multiplicity of non-core yet very important administrative functions and processes, while still giving their patients the proper care they need.

To address these challenges, over the last few years, Interswitch has developed a shared outsourcing infrastructure to help manage non-core functions such as record keeping, member identification, claims process, administration services and much more.  This means that health insurers and care providers are no longer burdened with these time-consuming tasks, and can focus on keeping their patients healthy instead.

INTERSWITCH HEALTH SOLUTIONS

Interswitch Health Solutions has at its core Smarthealth™, an automated service platform that processes day-to-day healthcare services easily and efficiently. This intuitive technology also offers biometric identification at hospitals, online submission and processing of claims, capitation payments and other payments such as salaries, vendors, suppliers, taxes and pensions.

Recently, they have added the mobile health enrolment verification service. This allows care providers to confirm eligibility in real-time by dialing a short code on mobile phone for authentication and request authorization for specialized services.

The process is further detailed in the video and below.

Challenge

Sector – Healthcare Funders, Scheme Managers such as Health Insurers, Health Maintenance Organisations, Third Party Administrators, Self- Insured Corporates

• Service bottlenecks where patient’s eligibility status cannot be verified easily
• Increased waiting times at service points
• Delay in provision of critical medical services
• High cost of providing personnel for verification and authorization to healthcare provider by Scheme managers
• No visibility on encounter of patients at point of care

Solution

• A short code dial *322*9999# that prompts for unique identification number
• Service sends an SMS with pertinent information of the patient
• Service provider request for authorization functionality for specialized services
• Immediate authorization or decline message to guide care providers
• Log of all visits with time, provider and location stamps
• Real-time reporting on service trends

 

This article is not an endorsement by GBCHealth or any members of its Board of Directors. GBCHealth does not endorse or recommend any commercial products, processes, or services.