United africa health services to insurer & health care providers

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Mauritius health Insurance and health care industry Challenges ; and United Africa Health solution .

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United africa health services to insurer & health care providers

  1. 1. “Enabling Business Innovation & Driving Growth Together”
  2. 2. Who we are ?United Africa Health , professional health care and tech start up in collaboration withAmerican medical practice group and investor backed health technology start up group .Our Experience : 150+ yrs. collective people experience in the health care , technology and InsuranceWhat we do ?Wellness promotion . Health care marketing & Benefit consulting . Health Administration .Health Risk Management . E- Health Records .Tele health . Tele Underwriting . Pre policy checkup . Health outsourcing skill development .International Outsourcing and advanced healthoff shoring support services We are innovative because : We Know to think without the box With us : WIN . WIN. WIN (every one is a winner )We love : “ To give more value & care to our customers “We ensure : Your savingsWe ASK our customers : why spend more , when your get more for less.We create : New health & technology enabled care experience to all our customers
  3. 3. UAH Solutions – snapshot Health benefit administration Contact centre BPO + H.Risk Management Payer /provider claims /Fraud/e-health risk processing assessment tool Tele/Medical underwriting Case management Scheme design Coding /billing services Pre policy check – life Health Technology & consulting E-health & wellness portal Health outsourcing training academy – VLE My wellness 2 wealth card E-Patient records International travel Real time claims assistance & medical adjudication tourism Mobile policy Issuance unit Online policy renewal /fin serve portal (e-distribution)
  4. 4. Our Vision: “To be one of the respected & innovative healthcare Industry supportservice provider “Our Mission: “United Africa Health ® exists to serve all health care & insuranceindustry stake holders in providing cost effective , innovative ,quality andadvanced value add e-enabled health support services.Our innovation goal ,is to implement wired care in Mauritius by end of 2013.Humanitarian Missions: “Grow to Give, Give to Grow “Executive socio vision: Building health skill and creating 3000 + outsourcing jobs inAfrica during the next 3 years, and contributes positive impact and change inRural Africa.
  5. 5. United Africa Health – Innovative technology enabled Wellness promotion and health care discountmarketing company” our advanced e- health platform simplify health record keeping, administration andenable new way of patient care, Patient engagement in Mauritius.We aim to promote Wellness & Care in Africa, and create access to convenient, safe, sustainable and affordablecare anywhere, anytime via Internet and telephone. UAH enable Indian ocean region health care industry to “GoGreen “a paperless health care environment with in no time and no initial cost.We at UAH thrive to create new healthcare opportunity to young Africa health professionals , enhance earning tomedical practice /providers and build health care skill in Africa by our unique service lines a. Tele health b. Healthoutsourcing c. Tele radiology . UAH unique services lines drive foreign revenue and more jobs in Mauritius andAfrica .United Africa Health - We simplify health care & Insurance industry challenges , as a result Oursolutions create highly technology enabled unified Health care environment and improve care, Industryperformance and profitability .UAH- “ we are unique , because of our business model , approach and technology” and we are cost effective ,with us 100% each and every one who engage with is a clear winner .“Guaranteed cost savings coupled with fresh health care experience”
  6. 6. Prabhumurthy (MA,MBA,CFP)Our founding Entrepreneur , young visionary and Professional executive start up . Managing partner –member team Eximius info tech & Co -founder - United Africa health, is a management graduate from one of Indias most renowned institutions and has a wealth of experience & 10 yrs. of success in Business development ,Marketing , business modeling , wealth advisory, outsourcing and international business . Before his start up initiative ,heading international business and strategy for Med scheme, one the largest health care group in south Africa , and he been instrumental towards developing and implementing global business strategy ,and in Identifying M&A transaction in the United States and Asia . Dr Abhithab Gupta Radiologist by profession with 20 + years of healthcare experience , he is regular faculty at NIA and have authored more than 10 medical book. Dr .Abhithab , held several Sr management and c- level position in India’s leading insurance and administration companies , wealth of health management experience and currently managing more than 5 million livesOur Strategic in India . His contribution toward developing innovative health insurance product and national e- health strategy is remarkable in the Indian market. Partners • Largest Health administration & outsourcing company in India & costa Rica , in total our partners administer over 8 million lives • American Physician group & ACO’s • Telemedicine group • Start up Tech & Health Outsourcing companies in the united states
  7. 7. Prabhumurthy , Dr Abhithab Gupta , Dr Eric , Dr Harish Singh , Dr Chan , Dr Singh, Mr Krishana praharaj , Mr Roy Sanders , Dr Lyness , Dr Bill Hall , Dr Andrew , & other International /Local Our Technical technical operations and process expert team, with relevant industry experience more than 20 +advisory team years . Our Technical advisory team has played a key high level role in large health care companies , IT/BPO, Investment firms ,Health administration group in India , Mauritius , south Africa, United States ,UK ,has rich domain expertise in the health care , BFSI and outsourcing space. Our approach to business : Collaboration . Globalization . Innovation We believe in : People , process , knowledge and technology We guarantee : Customer satisfaction ,value addition , cost savings , Innovation and growth to our partners .
  8. 8. Identified GAPs and Challenges• Building customer loyalty & multi channel engagement - “as is” good , but not the best• Growing the bottom line ,reducing cost ,controlling fraud ,improving Health Service level• Marketing and distribution – limited innovation in terms of Marketing &distribution modelling• Sales - Traditional product selling , no value selling happening• Product innovation - Health• Despite the fact , all the reputed insurers & health care providers have implemented high end technology , still battling to get out of the old habit of printing piles of paper ..• Early adoption & implementation to new age tool s & technology• Government : Creating jobs /building skill / boosting economic growth
  9. 9. How we help the insurer ,corporates ,health care provider , customer and economicdevelopmentInsurer : Our health services , technology and innovative business approach helps insurance companies to reduce thehealth claim cost ,administration cost , enable innovation and improve customer experienceScheme owners /corporates : Our “Well ness 2 wealth “health product design help corporates to manage their employeehealth and extend care at work place , and help them avoid health premium increase , create access to comfort care &wellness . “ Healthy Mind & Health y Body = more productive employee , happy family , healthy society”Health care providers : Our “wellness 2 Wealth “ product help provider to enable technology innovation , careinnovation , improved e- referral system , higher patient engagement , promote preventive care and well ness culture ,after all our product help the provider grow their business bottom line ,with no extra cost .Private practice : We help young medical practice with administration and practice management , mean while we alsohelp them improve practice earning s , by our allied health services.Customers : Our” Wellness 2 wealth “ product create access to advanced & innovative line of care , Savings up to 20% onhealth and financial services product purchase , E- health records , 24/7 Emergency assistance service , Unlimited access towellness portal , where they can self manage their health over a click, and more value deals around the island .Government : National health outsourcing skill building , in order to meet the health outsourcing service buyer marketcompliance , and as result a . we attract more USD /GBP/ EUR revenue in to the island b. More jobs c. More qualifiedskill d. improved citizen lifestyle e. We bring down youth un employment rate
  10. 10. Health care Distribution Technology Health Outsourcing AcademyHealth admin & Health Risk Management - Insurer /Scheme owners• “Product innovation “ - our preventive care & wellness approach will reduce your claims cost• Quite simple to differentiate your business from the competition , just supplement our value add service..• Real time reporting , Real time adjudication , Tele health underwriting , Instant issuance of health policy , printing e-card ,E- health records , predictive health risk modelling and many more features …..
  11. 11. Doctor Preventive care approach At UAH , your health business risk managed by qualified medical professional and global health risk managers Improved Provider performance &Reduced Claim cost plan Profitability
  12. 12. “My wellness 2 wealth” supplement card :Product feature & Benefit: - overview• Wellness and personal health portal unlimited access• Medical records on 1 GB flash drive• Second medical opinion – With local and international specialist• Tele medicine – Doc on call service *• Home care assistance and emergency care - on call or press of a button*• Out patient and preventive care plans• wellness and nutrition plan• Health Benefit and wealth consulting – Benefit experts• Access to more value deals and benefits ….
  13. 13. United Africa Health careHealth TM Distribution Technology Health Outsourcing Academy Business
  14. 14. “Promoting wellness and care , taking health care back to home “Just imagine …. All your customers will have access to our unique value add servicesPriority medic – Doctor visiting patient homeFirst consulting on call - for minor symptoms call your doctor helpline or connectonline“My wellness 2 wealth “ supplement planElderly Home care assistance – “Express your love and care to your elderly by giftingour home care assistance device ”In case of any un attended emergency situation, we alert your family members , yourphysician , near by health facility and alert the ambulatory service as well.E- Health records - “No more paper file , No more searching “ UAH 1 GB Flash Cardwill allow you to organize your personal care and treatment history, accessible anywhere any time, and over a click you can request a second opinion with any doctor ofyour choice .“Electronic health records & providing care via telephone & Internet”
  15. 15. Who will benefit from our product ?• Individual - savings on spending , new health care experience , comfort and extra care .• Corporate - Express their care for their employee wellbeing and by managing staff member health , they can avoid health insurance premium increase “ proactive approach towards saving cost “• Providers - Extensive marketing – meaning more sales , more revenue and visibility• Hospitals - Alternate platform to promote well ness and care• Insurer : Reduction in claims cost , healthy business bottom line.
  16. 16. United Africa Health –Our Services We create value to Health benefit administration + Contact centre BPOInsurance companies . Government H.Risk Management /Fraud/e-health Payer /provider claims processing risk assessment tool Tele/Medical underwriting Case management Customers Scheme design Coding /billing services Pre policy check – life Health Technology & consulting E-health & wellness portal Health outsourcing training academy – VLEorganizations My wellness 2 wealth card E-Patient records International travel assistance & medical Real time claims adjudication tourism Mobile policy Issuance unit Online policy renewal /fin serve portal (e-distribution) Hospital and private medical practice . International health administrators
  17. 17. United AfricaHealth Our Technology solutions Snap shot
  18. 18. TPA – Third Party Administrator TPA acts as a Facilitator between Insured & Insurer. Our product for TPA offers the following : Total benefit administration including hospital, daycare, and clinic claims processing. Rich, high performance reporting at-a-glance access to the information you need in just a few keystrokes. Automated Preauthorization Workflow for high speed processing of preauthorizations received by fax or mail. Advanced correspondence logging for single click access to Word documents, emails, or Excel spreadsheets previously sent to clients or insured, along with SMS and email push features. Automated Electronic Claims Queue Processing for Streamlined processed of claims. Open Architecture Database design allows access to data by your existing applications or reporting tools. In the process of HIPA compliance including security tracking, patient security features, and acceptance of all HIPAA data formats.
  19. 19. PHR (Permanent Health Record)
  20. 20. PHR (Permanent Health Record)
  21. 21. PHR (Permanent Health Record) PHR is a permanent health record on the web, which is lifelong archive of person’s medical history. It can be accessed online anytime, anywhere, and by anyone with the required security credentials.Permanent Health Record contains: Basic personal information Medical insurance coverage details Immunization records Medical history (past & current) Medication information Information of Allergies “Smart Tag” technology that keeps track of members information as a critical care access report which can be accessed in the case of a medical emergency
  22. 22. Benefits of PHR 24*7 access and handy source of entire medical history Pro-active approach to tackle emergencies Increased consciousness towards one’s own health Life time health insurance records and health checkup records Online health record accessible Members will be able to add, edit or upload new record as and when required Unique identification (username/ password) for everyone We can upload the scanned copy of original documents Tracking Of Insurance details 100% Accuracy
  23. 23. HRA (Health Risk Assessment)
  24. 24. HRA (Health Risk Assessment) Health Risk Analysis Provides an overview of personal health risk based on biological risk factors, normalized for age & sex, and medical history. Assessment of severity or likelihood of an adverse health outcome due to an exposure to environmental, biological, or social conditions through a comprehensive questionnaire. HRA helps in identifying & managing risks for different diseases. It is beneficial for program planning, implementation & evaluation. HRA reports also can be used for the research purpose & in policy development.
  25. 25. Pre Policy Health Checkup
  26. 26. Pre Policy Health Checkup (Dashboard view)
  27. 27. Products: Pre Policy Health Check Pre Policy is intranet/internet based web application providing common platform to the insurance company, corporate, individual, hospital provider & management where they can interact with each other. It is complete Business Optimization of Process of Health Check up, for clients who opt for Insurance Policy. Following are the main features: Exhaustive MIS for Insurance companies and corporate, Providers, Administrator. SMS and E-push integration throughout the system for periodic updates. Reporting of all processes, all appointments, TAT reports, and accounts reports Separate Logins for Agents, Development officers, Insurance companies, Corporate. Annual health checkup for corporate is available. Facility to customize the packages and rates for each Diagnostic Center, Insurance company, and corporate. Reports can be fetched in various formats as per the requirements. Integrated accounts module that takes care of invoices, debit note & Payment Received.
  28. 28. Pre Employment Pre Employment Health Check up is a Business Optimization Process of Pre Employment health Checkup for the Employee by Corporate. It is intranet/internet based web application providing common platform to their corporate, individual, hospital provider & management where they can interact with each other. Following are the features: Separate Logins for Agents, Development officers, Insurance companies, Corporate. Annual health checkup for corporate is available. Exhaustive MIS for Corporate, Providers, Administrator. SMS and E-push integration throughout the system for periodic updates. Facility to customize the packages and rates for each Diagnostic Center, Corporate. Reports can be fetched in various formats as per the requirements. Reporting of all processes, all appointments, TAT reports, and accounts reports Integrated accounts module that takes care of invoices, debit note & Payment Received.
  29. 29. Annual Health Checkup Annual Health Check up is a Health Check up Process for Employees by Corporate every year. It is intranet/internet based web application providing common platform to their corporate, individual, hospital provider & management where they can interact with each other. Following are the features: Integrated accounts module that takes care of invoices, debit note & Payment Received. Facility to customize the packages and rates for each Diagnostic Center, Corporate. Separate Logins for Agents, Development officers, Insurance companies, Corporate. SMS and E-push integration throughout the system for periodic updates. Reporting of all processes, all appointments, TAT reports, and accounts reports Annual health checkup for corporate is available. Exhaustive MIS for Corporate, Providers, Administrator. Reports can be fetched in various formats as per the requirements.
  30. 30. Tele - Underwriting
  31. 31. Tele - Underwriting
  32. 32. Tele - Underwriting Tele - Underwriting Teleunderwriting is a new tele-interview underwriting system for proposers seeking medical insurance policies. Features Immediate risk analysis - Our system enables the interviewer to analyze the risk for more than 40 common diseases on the spot. Effective Call center office automation – Optimizes the use of your call center and office manpower to save you money as well as increase efficiency. Health Data gathering – Which can be useful to insurance companies as well as the Ministry of Health. Benefits Increase productivity - spend less time on paperwork and more time doing what you do best meeting with clients and selling. Improve turnaround time - more detailed information to the underwriters, which reduces the need for the most time-encompassing requirements. Alleviate awkwardness - Applicants often prefer providing personal information to a third-party interviewer rather than face-to-face with an agent who may be a friend or associate.
  33. 33. Tele - Underwriting
  34. 34. Tele – Medicine• Interactive health care over distance using information or telecommunications technology• Telemedicine brings the expertise of a specialist to the point of care and allows that expertise to be customized to that patient• Telemedicine facilitates the provision of medical aid from a distance. It is an effective solution for providing specialty healthcare in the form of improved access and reduced cost to the rural patients and the reduced professional isolation of the rural doctors. Telemedicine can enable ordinary doctors to perform extra-ordinary tasks.• Using telecommunications and computers to exchange information to support medical decision making a. Medical Records – EMR and PHR b. Literature search c. Decision support d. Remote monitoring e. Consultation and Conferencing
  35. 35. Wellness Portal
  36. 36. Wellness Portal
  37. 37. Wellness PortalPortal Benefits:• Provide a focus for purchaser, provider and consumer communication.• Ensure timely and cost effective communication• Provide greater consumer access to information about health care providers• Enhance the community in healthcare networks• Provide a secure file exchange and storage environment• Provide technology to emerging consumer to consumer support groups for chronicconditionsWellness and Health Portals Sections:•Many content options and wellness and health programs•Implementation of client specific information, such as: • Medical Directories • Health Benefits for Employees•User progress and usage reports•Intranet and Internet accessible•Health Risk Assessments•Weight Control Programs•Disease Centers•Health Tools
  38. 38. Current TechnologiesMicrosoft .Net Platform 2.0,3.5: The .NET Framework is: Common Language Runtime – provides an abstraction layer over the operating system, Base Class Libraries – pre-built code for common low-level programming tasks, Development frameworks and technologies – reusable, customizable solutions for larger programming tasks. The .NET Framework allows applying common skills across a variety of devices, application types, and programming tasks, integrate with other tools and technologies to build the right solution with less work and Build compelling applications faster. We are using C#, VB.Net Languages with other features in ASP.Net.SHAREPOINT : Microsoft SharePoint, also known as Microsoft SharePoint Products and Technologies, is a collection of products and software elements that includes, among a growing selection of components, web browser based collaboration functions, process management modules, search modules and a document – management platform. SharePoint can be used to host web sites that access shared workspaces.
  39. 39. Current TechnologiesDATABASE LANGUAGE(SQL SERVER): SQL Server 2005 has reduced application downtime increased scalability and performance and tight yet flexible security controls. SQL Server 2005 makes it simpler and easier to deploy manage and optimize enterprise data and analytical applications. It enables you to monitor manage and tune all of the databases in the effective way. Failure of the primary system applications can immediately reconnect to the database on the secondary server using Database Mirroring. SQL Server 2005 provides a new capability for the partitioning of tables across filegroups in a database. Has Features of XML Multidimensional Expressions (MDX) and XML for Analysis (XMLA). Integration with the Visual Studio development environment provides more efficient development and debugging of line-of-business and business intelligence (BI) applications
  40. 40. Current TechnologiesWCF / WPF /WWF (WF) Windows Communication Foundation (WCF) is Microsoft’s unified programming model for building service-oriented applications. It enables developers to build secure, reliable, transacted solutions that integrate across platforms and interoperate with existing investments. Windows Presentation Foundation (WPF) provides developers with a unified programming model for building rich Windows smart client user experiences that incorporate UI, media, and documents. It provides Databinding, Built in Animation, Templates & Styles, Resource management. Windows Workflow Foundation(WWF) is a framework that enables users to create system or human workflows in their applications Microsoft Silverlight is a new cross-browser, cross-platform implementation of the .NET Framework for building and delivering the next generation of media experiences and Rich Interactive Applications(RIA) for the web. It runs in all popular browsers, including Microsoft Internet Explorer, Mozilla Firefox, Apple Safari, Opera.
  41. 41. We focus on building and enhancing the N-Layer Architecture, and hence all ourapplications are not very load-intensive on servers as the load is shared.Distributed Application Architecture is used where we can distribute application’sparts into multiple server.We focus on Making application’s ready for Web Form.Focus on distributing caching topologies.Integrated Application and Project Management techniquesFocus on Business Intelligence tools integrated within the application.
  42. 42. United AfricaHealth Thanks you Prabhu Murthy (MA,MBA,CFP) Entrepreneur & Sales optimisation Consultant Mob:+230 4231666 ; Skype : prabhumurthy PrabhumurthyM Prabhumurthy Maduraimuthu

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