Health Insurance System

Commercial Health Insurance System

Picture of employees of a health institution.

Asseco Commercial Health Insurance System is centralized multi-tier information system, developed by Asseco for commercial health insurance companies. It includes complete application program facilities for the administration and support of health insurance company activities.

It is built based on the long lasting experiences in developing and extending of the systems for health insurance and contains the latest modern technologies knowledge. It is an universally usable and modifiable system based on relational database technology. The system is integrated with an Internet portal and electronic registry (eHIP) for contact between the customer and their clients and partners.

The IS can be connected to other supportsystems (MIS, call centre, registry...).

Key Functionality

	General ledger, code lists and catalogues, account classification, schedule, records, monthly and annual balance sheet, technical reserves, conjectural items, rectifying items, asset and liability accounts, VAT
	Register of policyholders, insurance relationships, indemnity, communication with the central register of policyholders, EU forms
	Register of payers, payers’ payment plan, communication and notification duty against the Health Policy Institute (ÚDZS)
	Register of healthcare providers (PZP) – out-patient care (physicians), policlinics, pharmacies (optical stores, medical aids distributing points), specialized out-patient care, hospitals, spas, rescue service, hospice
	Register of agreements with PZS, agreement templates, creation of agreements
	Clearing of records from PZS (capitation, operations, pharmaceuticals, aids, hospitalization, ...), reviewing of records from PZS, PZS invoices, debit note, credit note, spa and external treatment, recovery of claims for a policyholder from the EU
	Insurance management – tax return, self-payers’ prescriptions, monthly records, payments, prepaid insurance, premium refunds, mutual credits, insurance acquisition – cash register, annual account processing
	Notices and insurance payment bills, penalties, regresses, penalty acquisition – cash register
	Controlling, enforcement, distraint, bankruptcies, administrative procedures, payment plans
	Processing of other settlements, error payments, payment orders, bank account statements, postal orders, settlements via State Treasury
	Customer and supplier invoices, statistics, reports, operative print reports
	IS administration

References

	Union zdravotná poisťovňa
	Všeobecná zdravotná poisťovňa