Acess Meditech - Transforming the Health Insurance Sector with Robust and Interoperable Underwriting

CIO Vendor The health Insurance industries world-wide are in a state of flux as they are facing severe operational aches owing to stricter compliance regulations, exploding customer information and risk of infringement. They are unable to achieve greater efficiencies to manage huge volumes of data in a secure environment. Furthermore, they fail to provide customers with timely access to information on-the-go. The high-on bottleneck prominent among these challenges is the lack of automation and innovation in distribution, delivery and operations. However, Acess Meditech, headquartered in Hyderabad, automates and streamlines various operational processes of insurance industry by leveraging TOSHFA –a web enabled Integrated Health insurance Management ERP system. TOSHFA is user-friendly, robust, sophisticated yet flexible and customer centric”, says Syed Aijazuddin, the CEO and MD of the company. The company being certified as CMMI Level3 works inexorably to transform the health insurance industry with its robust and interoperable Underwriting & Claims Management Services.

Empowering Health Insurance Providers with Automation
TOSHFA comes circumscribed with various scalable features that can be used by Insurance Companies, Third Party Administrators (TPAs), Health Maintenance Organization (HMO) and Managed Care Organizations (MCO). The enrolment of the claimant after obtaining the claim form takes place within the sponsored company and the sponsored company has to undergo the pain of keeping an army of people to handle the entire process of enrollment, card issuance and cards processing. “As per present market practices; there are many claims entry operators, claims adjudicators and processors who enter the claims on a regular basis with hurdles at their best; which is totally automated with bulk upload and processing validated by the policy terms and conditions”, adds Syed. To streamline insurance operations and reduce process complexity including cost, Acess Meditech provides an advanced e-portal allowing its users to handle and carry their insurance business more effectively than any conventional enrollment process. While proactively managing compliance, the company is focused in increasing customer satisfaction and loyalty with better services. “With our paperless e-portal, the bulk upload and processing is totally automated negating reliance on employees to process thousands of claims”, quotes Syed.

The insurance industries face severe head winds and incur loss due to improper policy terms and conditions. Underwriters fail to underwrite policies other than the basic plans in the mature markets. In addition, claims do not get submitted on time and by the time it is entered there arises a gap between the claims entered and processed, consequently failing to impart a correct idea to underwriters about the actual loss ratio of the portfolios. Acess Meditech’s approach in terms of solutions and service has always been customer - centric and implements best strategies to ensure timely processing of claims. The company is focused in uncovering the patterns for raising productivity in the health insurance sector with its flexible and scalable solutions. Under the guidance of Syed Aijazuddin, the company fulfills the Insurance Market needs and simplifies Insurance business operations.
His wide experience has brought in to grab the Health Insurance Market with its robust Software Solutions. With an extensive expertise in IT and health Insurance, Syed is inclined towards achieving sustained and superior ROI by way of innovation.

Acess Meditech provides an advanced e-portal allowing its users to handle and carry their insurance business more effectively than any conventional enrollment process

The Future Roadmap
With a vision to make insurance a very transparent, process for all insurance stakeholders such as Stakeholders, Brokers, Insurance Companies, Providers and Reinsurers, Acess Meditech wants to expand its wings by providing its solutions to the advanced market of US/Europe, nascent market of Africa and regulated market of Middle East. Acess Meditech envisages of becoming a global leader in Underwriting & Claims Management and processing using best available technology. “We want to provide our valued customers quality and advanced solutions to their satisfaction”, concludes Syed.


Salient Operational features of Health Insurance Services
• Online Employee Portal: To manage the Underwriting/Quotations & Policy Administration, Member Enrollment, Pre-authorization, Claims Adjudication, Accounts and Comprehensive business intelligence Reporting.
• Online Provider Portal: To verify member eligibility, process online Pre-authorization requests and claims adjudication.
• Online Corporate Portal: To process online Member Additions and Deletions.
• Online Reinsurance Portal: To manage the Reinsurer Treaty processes including the MIS Reporting Engine.
• Online Member Portal: To access and check the policy eligibility data and status of the Pre-authorizations and Claims Processing.
• Regulatory Compliance & Reporting.
• E-Portals & Self Service Portals.
• Mobile Apps.

Mission of Acess Meditech
To be a global leader in Underwriting & Claims Management processing, using best available technology, to provide our valued customers quality, competitive and advanced solutions to their satisfaction while serving the community. Our employees and business partners will share our success, and our shareholders will receive a sustained, superior return on their investment.

Awards and Accomplishments
Acess Meditech has been appraised at Level 3 of the CMMI Institute’s Capability Maturity Model Integration (CMMI) by Carnegie Mellon University.