HALLESCHE: Efficiency through electronic claims processing

3500 claim cases per day are investigated in a non-paper format, released for processing and electronically archived

Stuttgart, June 16, 2010
By moving to a digital processing of claims, the HALLESCHE Krankenversicherung highly improves the efficiency of its administration. The persons responsible decided to use the document management system of the producer OXSEED to process claims.

The key processes for reading, investigating and processing of documents are already handled by IT systems of the HALLESCHE Krankenversicherung. Since the year 2003, the software of OXSEED supports the insurance company’s handling of about 3500 claims per day.

In the first phase, OXSEED sorts and electronically files the documents into folders for the insured policy holders and distributes them to the workbaskets of the claims adjusters – here is the entry point for claims to flow into the claims processing system. Subsequently, the claims adjuster can use the application “OXSEED I-VIEW”, which is integrated in the claims processing system, to view and process the line items of individual documents of the claim. They investigate the claims, add notes to a document , split and associate invoices charge amounts to their respective areas. They finally send the settlement information for further processing to the claims processing system.

The HALLESCHE Krankenversicherung decided to equip their work stations with the browser-based software of OXSEED. All applications are hosted on a mainframe in the insurance company’s computing center. The claim adjusters only need a standard software browser, such as Microsoft Internet Explorer, to work with the data and documents and to communicate with the policy holders.

The deep integration of the browser-based document management system with their insurance applications is considered by the HALLESCHE as a success factor for the quality improvement in their operational processes.

“In their conversion of the paper-bound processes to digital processing, we were able to support the persons responsible at the HALLESCHE Krankenversicherung”, says Wolfgang Maas, member of the executive board at OXSEED AG. “The major reason for the decision of HALLESCHE was the capability of OXSEED to mirror all steps of the process”.