The central element of this solution is a platform

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The medical aid process is part of the service billing process. Similar to the current billing process for medical aids, manual processing steps can be found in all areas. The potential for automation here is enormous - from the scanning software to the technical and tariff-related checks.

adesso offers corresponding scanning and inspection software or is currently developing it. Through a process analysis with our team of experts, we can determine how the software can best be integrated and configured in order to minimize manual work steps. At the same time, the use of fraud detection software can be examined, always depending on the needs of the private health insurance company.

We have also used our professional and technical expertise in the area of ​​company health insurance (bKV) to develop a user-centered solution for employers and employees and to offer a process for private health insurance that reduces administrative costs.

which the health insurers' systems are connected via interfaces singapore consumer email list for the automated processing of new contracts and services. There are two access points for this platform: a web portal for the employer and a web app for employees. Both channels can be used by the private health insurers to place additional offers. User convenience, smooth processes and an expanded range of offers are the focus.

The advantage of our solution for private health insurance is the fully automated creation of participants and subsequent processing of benefits. There is no administrative effort, so that the tariff can be calculated at a reasonable price and is therefore competitive.


Gematik-related activities
The digital transformation in the healthcare market is reflected in the activities of Gematik, whose specifications in the area of ​​statutory health insurance are adapted for private health insurance with the PKV association. This is often a lengthy process. However, it can be assumed that the electronic patient file (ePA), the electronic certificate of incapacity for work (eAU), the electronic prescription (eRezept) and the electronic prescription (eVO) will also have to be available to private health insurance policyholders in the future. This in turn gives rise to many fields of action and potential for prevention and rehabilitation.

adesso has entered into a preferred partnership with the technology manufacturer RISE to support customers in the private health insurance sector in the introduction and further development of the ePA with innovative added-value functions, technologies and services based on the certified RISE technology. The setup, integration, operation and service for the ePA are thus provided from a single source.