What is HIPS?



agosto 24 , 2015 | Posted by admin |

What is HIPS?

The HIPS system is a comprehensive and integrated solution that covers every aspect of health insurance administration. From credentialing providers through claims reimbursement and electronic payment, HIPS is designed to maximize scalability and minimize administrative costs by working in a completely user friendly web-based environment.

Some of the key benefits of the HIPS are:

  • Optimizing business processes by creating them fast and accurate.
  • Flexible business rules’ programming. From defining the age range of women to control surgeries pre-authorizations and more.
  • HIPS includes a flexible finance component that allows users to generate and post transactions created by the internal system processes such as claims and premium billing.
  • Our security settings allow designated personnel to tailor a detailed security configuration and controlling access to data.
  • Workflow automation is applied to all major processes, as well as reporting and correspondence, allowing clients to configure and schedule the system activities.
  • The system is scalable and can be adapted to clients’ particular needs and meet the needs of thousands of providers at the same time.
  • We can provide clients with a level of audit control useful to recording their system information and activity.
  • HIPS compliant with HIPAA standards and can be implemented with both offline and online capabilities.

HIPS provides the full range of services needed for national health insurance schemes – from basic-level insurer registration, medical treatment and  includes specialized features such as billing and payment processing and system performance review,It also gives a service for all users – health planners, purchasers and providers.

HIPS provides six main modules that helps health insurance schemes going accurate.

Providers Module. Here all health care providers are registered and profiled. New providers, from hospitals to pharmacies and all other types of providers can be added.

Contract Module, which is designed to help manage all provider contracts. This includes capturing important provider information, provider’s infrastructure, human resources, and the package for health insurance, etc.

Insured Module provide user-friendly forms to capture and manage key information for all individuals enrolled with insurance, such as SSN, marital status, residence address, family and work information.

Payment Module In this module, we provide users the capability to manage the reimbursement process to providers for activities performed in a given period. HIPS allows for different payment mechanisms including: capitation, fee-for-service and DRG payments.

Reporting Module where users can create reports, in either table or graphical format for issues related to members, health centers, productivity, payments, demography and morbidity. Support Module to allow users to report errors, inquiries or requests for assistance to system administrators. All transactions are fully documented and allow for thorough system audits by user.

Available as a SAS or proprietary installation,  the HIPS system is a comprehensive , integrated  and cost-effective solution that covers every aspect of health insurance administration