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The Challenge

Insurers have to establish efficient
processes to remain competitive. In
order to cope with the very high
manual effort, INTER health insurance
was looking for a powerful system to
support the billing of care services. The
new system had to be connected to
numerous peripheral systems such as
Partner, Exkasso and Bestand. This is
only possible with a mature interface
concept.

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The Solution

The introduction of the standard
software in|sure Health Claims in the
service management of the long-term
care insurance made it possible to
significantly increase the efficiency of
work processes. Existing invoice data
from incoming items are taken over by
the system and the refund is
calculated according to the tariff
model. The design and testing effort
was low because in|sure Health Claims
has already implemented the complex
industry-standard pool tariffs of the
long-term care insurance in its
standard version.

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The Outcome

With in|sure Health Claims, INTER
health insurance is now able to handle
day-to-day processes in long-term
care insurance and to manage the
resulting work with existing
employees. Administrators are
provided with automated support in
the calculation and reimbursement of
care benefits. Recurring payments and
the commissioning and processing of
care reports are fully automated
within the new system.

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There had already been a need for change for a long time, especially in the area of long-term care insurance. Over the first year, the benefits of the new system became increasingly visible. After one year, we now have a balanced work situation. And the colleagues at adesso have familiarized themselves so well with the system that I would employ them as administrators at any time.”

Frank Herbold - Manager, Long-Term Care Insurance

Download the complete case study in PDF format here.

The PDF document contains the complete case study of the client INTER Krankenversicherung, with the challenges, solutions, project timeline and outcome of the "Using a System to Automate Long-Term Care Services" project.

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About the Client INTER Krankenversicherung AG

INTER Krankenversicherung AG developed from the “Emergency Aid” health support fund, which was founded in 1926. The company offers the entire product range of private health insurance for the comprehensive health care of its policyholders. Its comprehensive customer service includes numerous assistance services. INTER Krankenversicherung AG is one of the financially strongest companies in the private health insurance industry.

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