IzemEBS

Izem Employee Benefits Solution (IzemEBS)

Start-up business, SME, global enterprises, whichever one you may be, IzemEBS offers you the flexibility and the freedom to manage your employee healthcare benefits without any third party.

With specialised expertise, IzemEBS modules cover many major parts of employee healthcare claims including claims management, assigning entitlement & limitation, manage service provider and most importantly pay direct to the service providers without using any third party service.

Try out the six (6) months free trial with no obligation to renew.  IzemEBS is a very affordable cloud-based system. Click here to sign-up for your free trial now.

With IzemEBS’s claims platform, you can handle a wide variety of claim types.  You can administer Medical, Dental, Vision, and Hospital, seamlessly, in one easy to use platform.  In addition, there is a full Suspense Module and Audit Module for additional claims managements.

Claims Processing
  • Easily manage all your claims in a single claims module. Each claim entry is captured with all the relevant information for the selected claim.
  • Customise your user experience with user-defined tab orders and security access.
  • Easily navigate to any related component using hyperlinks.
  • Easy to use lookups for all pieces of claim information.
  • Easily identify and handle duplicates with user-defined rules for soft and hard matching criteria.
  • Full auto-adjudication that runs 24/7 based on claims placed into the queue. Queue up claims on a schedule or instantly to best manage workflow.
  • Print the details directly from the selected claim.

Suspend claims using custom criteria.  Categorise suspended claims and return them for additional review or release them for funding.

System work flow chart:

Claim Services:

With IzemEBS’s claims platform, you can handle a wide variety of claim types.  You can administer Medical, Dental, Vision, and Hospital, seamlessly, in one easy to use platform.  In addition, there is a full Suspense Module and Audit Module for additional claims managements.

Claims Processing
  • Easily manage all your claims in a single claims module. Each claim entry is captured with all the relevant information for the selected claim.
  • Customise your user experience with user-defined tab orders and security access.
  • Easily navigate to any related component using hyperlinks.
  • Easy to use lookups for all pieces of claim information.
  • Easily identify and handle duplicates with user-defined rules for soft and hard matching criteria.
  • Full auto-adjudication that runs 24/7 based on claims placed into the queue. Queue up claims on a schedule or instantly to best manage workflow.
  • Print the details directly from the selected claim.

Suspend claims using custom criteria.  Categorise suspended claims and return them for additional review or release them for funding.

IzemEBS Features :

Employee List:- Display all employees.  Easily manage your new & resigned employees and their dependents.

Benefits Entitlement; Flexible and dynamic platform, allows you to plan your employee benefit entitlement.  You can control every aspect of claims payment and auto-adjudication. 

Plans
  • Configure Plan Year, Lifetime and Annual limits for by the Individual and the Family.
  • Configure Family and Individual level maximums for Deductible and Co-Pay.
  • Customise visitation by per Visit, per Month or 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. Simplifies setup and allows for many plans to be built quickly with little or no additional setup.

Claims :

Online Claims Authorization; with this feature, you can rest easy knowing that you have a robust claims management and prior authorisation process.

  • Track everything you need for pre-authorization processing. Allow you to screen each claim along with diagnosis, prescription and procedure information submitted by service providers.
  • Dynamically configure the pre-authorization process to allow for a more robust authorisation and satisfaction of approved authorizations.
  • Auto-adjudication takes all settings into account and gives the user an informative selection process when multiple matching authorisations found. When an exact match found, adjudication will automatically process the claim with the assigned authorization and update the appropriate actuals on the authorization.

Manual Claim; Allow you to keep track the utilisation of the benefits for cash paid claims claimed by your employees.

Visitation e-Slip; Enable to generate visitation slip electronically for your employee to visit the service provider for treatment.

Service Provider :

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

Users & Security :

Security; this feature 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. 

  • 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. Customise groups and users assigned to those security areas for the given access level.

Reporting :

Get true insights and analytics into your employees’ benefits utilisation.  The reporting and analytics make it easy to capture and report on any employee benefits utilisation.

Visual dashboards to view trends

Quickly generate meaningful insights from all of your employee data to see historical benefits utilisation trends and predict future outcomes.  Charts include an average summary of benefits utilisation employees and family in term of amount, visitation and medical leave.  Further analysed branch and department.

Pre-built reporting :

Numerous pre-build reports will help to keep you compliant, including affordability and eligibility for benefits coverage.

Communication :

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