Transforming Healthcare Claims: DOH eClaims Platform Success
/ Case Study / Transforming Healthcare Claims: DOH eClaims Platform Success

Transforming Healthcare Claims: DOH eClaims Platform Success

Issues

The Department of Health (DOH) aimed to deploy an Eclaims platform to streamline exchanges between health providers and insurance companies, improving efficiency and transparency in claims processing.

Solution

A comprehensive digital platform was designed, customized to DOH specifications, developed, and successfully implemented to collect claims from health providers and insurers. The platform integrates business intelligence capabilities, enabling the generation of annual reports and dashboards supporting all DOH departments involved in financing, licensing, and public health.

Approach

The rollout was supported by a robust change management plan to help stakeholders transition to new claim submission processes and ensure broad adoption of the platform.

Recommendations

Key recommendations included proactive change management, vigilant data security measures, continuous user feedback collection, and thorough scalability planning for future expansion.

Engagement ROI

The DOH achieved 90% data completion for all medical visits and prescriptions through the eclaims platform. Several hundred reports are now generated by the system, serving management and department officers across all DOH units.

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