Card Service Management System (CASE-MS)
CASE-MS (Card Service Management System) provide functions required for the implementation of the Medical Card in our client’s clinics or Health Check Centres around Hong Kong.

Business Needs

Medical cards are issued by insurance company and corporate are more commonly seen today. Each Medical card comprises an individual medical scheme and that implies lots of data management including different contract terms, member information and service provider information. Every visit by a member involves Member verification, eligibility check and claim submissions among different locations, these tasks provide heavy workload for the front line staff. Back office staff has to verify the claim submitted from the service provider/ member after service is provided. Approved or rejected claim should be followed up with bills clearance among member, service provider and the client which are tedious and easy to make mistake. As a medical service provider, our client would like to have a solution for implementing the medical cards in their service in an electronic way.

Our Solutions

User friendly interface are provided for user to managing Member Information, Medical Contract Information and Providers Information. Not only inputting the record one by one, CASE-MS allows user to upload member information, contract information and provider information with MS Excel. Information can be retrieved/ updated easily and effectively after all required data are loaded to the system.

In order to reduce the workload of the front end staff, online member verification, eligibility checking are provided. Service limits are more easily identify and overuse of granted service can be avoided. As most of the data are available in the system, the front line staff can save more time on filling in claims form and can submit the claims online to the back office.

Back office staff can verify the claims submitted by the providers online. The Approved/ rejected/ adjusted claims should be settled/ cleared by the corresponding parties. Invoice/ Statement can be printed easily after the verifications of the claims are completed. Various Reports are also provided to the back office for analyzing purpose.

Other than that, CASE-MS provides sophisticated features like:
  • Member Site/ Provider Site for member/ provider to check statement/ invoice of their own.
  • Setting up of news or Form download page for member/ provider.
  • Data setup module for maintaining the data more easily.
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