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Features

Izem Employee Benefits Solution (IzemEBS) Features

Employee

List; Easy management of new & resigned employees and their dependents, tracking of benefits utilization by branch and department.

 

Benefits Entitlement; you are given a highly flexible and dynamic application for plan and benefit entitlement setting. You can control every aspect of claims payment and auto-adjudication.
Plans
Configure Plan Year, Lifetime and Annual limits for by the Individual and theFamily.
Configure Family and Individual level maximums for Deductible and Co-Pay.
Customize visitation by per Visit, per Month or per Year.
Benefits
– Highly configurable benefit entitlements that allow auto-adjudication to select the defined benefit automatically without user interference.
– Benefit entitlements are defined independent of plans and can be assigned, dynamically, to the required Plan. This simplifies setup and allows for many plans to be built quickly with little or no additional setup.

 

Claims

Online Claims Authorization; Utilizing Online Claim Module you can rest easy knowing that you have a robust claims management and prior authorization process.

Track everything you need for pre-authorization processing. Allow you to screen each claimalong with diagnosis, prescription and procedure information submitted by service providers.
Dynamically configure of pre-authorization process to allow for a more robust authorization and satisfaction of approved authorizations.
Auto-adjudication takes all settings into account and gives the user an informative selection process when multiple matching authorizations are found. When an exact match is found, adjudication will automatically process the claim with the assigned authorization and update the appropriate actuals on the authorization.
Manual Claims Authorization; Allow you to keep track the benefits utilization for cash paid claims claimed by your employees.
Visitation e-Slip Authorization; Enable to generate visitation slip electronically for your employee to visit the service provider for treatment.

 

 

Service ProviderProvider Services – A key component to an administrative application is the ability to manage and maintain provider information. With Provider Services module you can easy viewed all provider data including demographic information, provider types, specialties and operation hours. Choose preferred service providers out of the available provider in our database.

 

Users & Security

Security Services – Security Module allows you to secure every object and report in the application. Each object and report can be restricted to Admin, Update or View access through user defined security areas. Secure data within those objects and reports with data level security provided by Izem Security Services.
Security
Create user groups and assign security access for all defined users.
Define access levels for each screen as View, Update or Admin.
Create security areas defined by screens and/or reports. Customize groups and users assigned to those security areas for the given access level.

ReportingGet true insights and analytics into your employees’ benefits utilization. The reporting and analytics makes it easy to capture and report on any employee benefits utilization.

Visual dashboards to view trends
Quickly generate meaningful insights from all of your employee data to see historical benefits utilization trends and predict future outcomes. Charts include average summary of benefits utilization employees and family in term of amount, visitation and medical leave. Further analysed branch and department.
Pre-built reporting
There are numerous pre-build reports that will help to keep you compliant, including affordability and eligibility for benefits coverage.

 

Communication

Communication module provide you an easy communication way with service provider for any discrepancies on claims & payments and support request from us.