Bespoke IT Platform - Claims Management & Client Portal
GENESIS
has developed a bespoke IT platform that provides back-end support for the management of claims data and front-end support through a user-friendly cloud-based client portal. As reflected in the Wi-Fi logo embedded in the
GENESIS
logo, we are champions of the use of technology to improve accuracy, efficiency, accessibility and connectivity to enhance our Clients’ experiences.
The CMS gives
GENESIS
the ability to collate Clients’ data to support the effective settlement of claims. This also allows for greater accountability when engaging Insurers with queries. Actually, Insurers often reach out to us for data and information to facilitate their processing and settlement.
GENESIS
Inspired
is a secure cloud-based interface which provides instant real-time data to plan members and designated management. This portal may be accessed on any internet-ready device (computer, laptop, tablet, smartphone, etc.) using a secure password. This innovation assists in reducing the workload of the Human Resources Departments and Plan Administrators for their Benefits Administration. Members would no longer need to go to their Plan Administrators to obtain information about their Group Health and Life Benefits. They would now be able to privately access their information using the GENESIS
Inspired
Client portal.
GENESIS
Inspired
enables the Plan Member to:
- View their Schedule of Benefits (SoB)
- View copies of all claim documents submitted to the Insurer
- View copies for all Explanations of Benefits
- View an interactive map showing network provider listings
- View the remaining balances on: deductible, maternity, vision and dental benefits
- View their claims history and status data
- Submit queries to GENESIS which will be addressed within 48 hours
- View reports for Plan Administrators and Management to assess the Group Health Plan’s usage and Performance (secured Manager access).
Plan Monitoring and Reporting
GENESIS’ reporting framework was designed to empower our Clients’ Plan Administrators and Management with the information needed to make decisions regarding their Benefits portfolios. The data for the Benefits Reports is generated from
GENESIS Inspired
and is referenced against Insurer reports, where available.
Knowing the performance of any Group Health plan is important to both the Plan Administrator and Management. Periodic reports identify trends and inform whether the Schedule of Benefits meets the needs of plan members and dependents.
GENESIS:
- Prepares detailed analysis reports to monitor plan performance by examining the claim patterns and claims vs. premium summaries
- Identifies developing trends based on analysis of the information
- Prepares and presents periodic plan audits
GENESIS’ exemplary record-keeping and systems for data collection, storage and analysis facilitates the provision of reports that are meaningful and insightful.
