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Configuration "Assistance. Medical Assistance" on controlled forms, based on the typical configuration "BAS Accounting, rev. 2.1"

  • Учет договоров и полисов страхования:

    • Учет программ и опций страхования;

    • Учет пакетов страхования;

    • Учет исключений;

    • Учет разрешенных контрагентов, франшизы, лимиты;

    • Учет уровней клиник;

    • Контроль лимитов и страховых сумм;

    • Автоматизация импорта полисов страхования;

    • Автоматизация загрузки программ страхования, исключения.

  • Учет застрахованных лиц:

    • Автоматическая идентификация при входящем звонке;

    • Авто-создание и идентификация при загрузке полисов;

    • Анализ лимитов, отчеты по расходам.

  • Учет страховых случаев:           

    • Автоматизация процесса урегулирования случаев;

    • Ведение мониторинга;

    • Регистрация оценки качества обслуживания и отказов в обслуживании.

  • Ведение взаиморасчетов с контрагентами:

    • Взаиморасчеты с поставщиками услуг и медикаментов;

    • Автоматическое разнесения отчетов от контрагентов о выполненных услугах и поставке медикаментов;

    • Взаиморасчеты со страховыми компаниями: формирование отчетов, выставление счетов, регистрация актов. Контроль взаиморасчетов на всех этапах.

  • СRМ:

    • Учет внутренних задач: адресация задач пользователям, контроль выполнения;

    • Интеграция с телефонией (как дополнительное решение);

    • Бизнес-процесс «Страховой случай», автоматическое формирование задач пользователям по урегулированию страховых случаев (как дополнительное решение);

    • SMS-информирование, электронная почта.



Industry Medical clinics, medical institutions  Medical and technical assistance  
Category Additional settings  Controlled forms  Assistant companies  
Type Management Accounting  
Cofigurations Accounting for Russia and Kazakhstan, edition 3.0  BAS Accounting, edition 2.1  
Configuration "Assistance. Medical Assistance" on controlled forms, based on the typical configuration "BAS Accounting, rev. 2.1"
from
UAH 200 000
Buy
Full description

List of functions of the module "Assistance. Medical Assistance" for configurations "1C:Підприємство" on managed forms:

  • Accounting for contracts and insurance policies:

    • Accounting for insurance programs and options;

    • Accounting for insurance packages;

    • Accounting for exceptions;

    • Accounting for authorized counterparties, franchises, limits;

    • Tracking the levels of clinics;

    • Control of limits and insurance amounts;

    • Automation of import of insurance policies;

    • Automation of loading insurance programs, exceptions.

  • Insured persons accounting:

    • Automatic identification on incoming call;

    • Auto-creation and identification when loading policies;

    • Analysis of limits, reports on expenses.

  • Accounting for insured events:           

    • Automation of the process of resolving cases;

    • Monitoring;

    • Registration of service quality assessment and denials of service.

  • Conducting settlements with counterparties:

    • Settlements with providers of services and medicines;

    • Automatic posting of reports from contractors on the services performed and the supply of medicines;

    • Mutual settlements with insurance companies: generating reports, issuing invoices, registering acts. Control of mutual settlements at all stages.

  • СRМ:

    • Accounting for internal tasks: addressing tasks to users, monitoring performance;

    • Business process "Insured event", automatic formation of tasks for users to settle insurance claims (as an additional solution);

    • SMS informing, e-mail.

The configuration is implemented on the basis of the standard configuration "BAS Accounting, revision 2.1". 


More about features


1. Document "Insurance contract".

The document is intended to record all contractual conditions of insurance in the "1C:Підприємство" database, namely: 

  • Contract period, policyholder, insurance company;
  • Policy for insured persons;

  • Insurance contract exceptions;

  • Insurance packages;

  • Insurance program - groups of services, categories of services, limits on them;

  • List of counterparties who are allowed to carry out the settlement of insurance cases;

  • Information materials - physical files: list of insured, insurance program, insurance contract itself;

  • Series under an insurance contract, example: individuals, law firms.



Fig. 1. The document "Insurance contract". The main form of the document. List of exceptions to the insurance contract.





Fig. 2. Insurance contract. Insurance program: types of services, groups of services, limits on them.





Fig. 3. Insurance contract. Insurance programs (insurance packages), insurance amounts by programs.

2. "Insurance policy" document. 

Document contains information on the insured person: 

  • Assistant affairs;

  • orders to the supplier;

  • denials of services.



Fig. 4. "Insurance policy" document. Main form.


3. "Coverage Analysis" report.

The report makes it possible to check the volumes of services already ordered for the insured at the moment by various groups and options, as well as to see the rest of the limit.




Fig. 5. "Coverage Analysis" report. Performed from an insurance policy.
Shows all information on the policy: insurance program, limits, allowed hospitals, deductibles, clinic levels.





Fig. 6. "Coverage Analysis" report. Data on coverage of the insurance program by individual and aggregate (total) limits.


4. The document "Assistance business".

The document registers an insured event when the insured person applies.




Fig. 7. Document "Assistance Delo". The main dialog form. Data on the insured event. Monitoring (diary) of an insured event.

The printed form of the Assistance Case Monitoring reflects the entire chronology of events of this insured event.


Fig. 8. Assistance business. Print form "Monitoring".

5. "Supplier order" document.


The document fixes the list of services or goods ordered for the insured person in the assistance case in a medical institution.




Fig. 9. Supplier order document. Pre-ordering services in medical institutions, ordering medicines in pharmacies.

In the document order to the supplier there are printable forms:

  • invoice order;

  • Letter of guarantee.





Fig. 10. Supplier order document. Printed form "Letter of guarantee" for medical institutions for ordered services for insured persons.


5. "Statement of expenses" report.

The report analyzes the correspondence of the invoiced amounts in the documents "Order to the supplier" and the reflected amounts in the documents "Fixing the expenses" received from the providers of medical services/goods.




Fig. 11. "Statement of expenses" report.


6. Document "Reported to IC (insurance company)".

In the document Reported to the IC, the list of amounts to be reimbursed by the insurance company is filled in (expenses incurred for assistance cases).




Fig. 12. Document "Reported to the IC". Basic form. The tabular section is filled in with a list of expenses incurred.

A printed form is sent to the insurance company to cover the costs.



7. "Insurance Company Indemnity" Report.

The report shows the accrual of the insurance company for compensation and what is closed by payment.




Fig. 13. Appearance of the report "Indemnity from the insurance company".



8. Business processes.

BP provide an opportunity to move to process management and qualitatively improve the activities of an enterprise by automating business processes. Business processes in the system are designed to combine individual operations (tasks) into chains of related actions, which will lead to the achievement of a specific goal.



Fig. 14. An example of a business process "Outpatient treatment".


9. Tasks.

User tasks in the system allow you to keep track of tasks by performer and serve as a reflection of the progress of business processes along the route points. At the same time, User Tasks can be created not only by business processes, but also directly by users.




Fig. 15. User tasks on the start page "1C:Підприємство".



The rights to the module are reserved (certificate No. 36092). We provide favorable terms of cooperation for partners.


Configuration cost: from 200000 UAH

Regarding price:

Contract No. 1: Subsystem "Assistance. Medical Assistance": UAH 200,000, where 130,000 is the cost of the subsystem "Assistance. Medical Assistance" and 70,000 is the cost of deploying the system, setting access rights. Within the framework of this agreement, we achieve that the functionality of the "Assistance. Medical Assistance" subsystem works.

Contract No. 2: (implementation and maintenance). Within the framework of this agreement - consultations on the use of the module, as well as additional settings. Minimum contract term: 6 months at UAH 36,000 (60 hours per month at UAH 600).


Developer: Company "NCT"
www.nct.ua
info@nct.ua



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Review for 30 minutes of free work on settings and consultations

Garant-ASSISTANCE LLC Garant-ASSISTANCE LLC
LLC "NCT" has been cooperating with LLC "Guarantor-Assistance" in the framework of medical, technical assistance and accounting since the beginning of 2005.
For more than eight years of collaboration, NCT LLC has established itself as a reliable partner providing high-quality services.
Services provided as part of medical, technical assistance and accounting support correspond to the level of requirements of Garant-Assistance LLC in terms of the quality and speed of their provision.
The company management expresses its sincere gratitude for the cooperation and hopes that together we will be able to ensure and maintain continuous positive development in this direction.
LLC "EuroAssistance" LLC "EuroAssistance"
EuroAssistance Limited Liability Company expresses its gratitude to Sergey Nikitovich Gashuk for successful cooperation in introducing, configuring and improving software for the medical assistance department.
The system of automation of operational accounting of the assisting company / loss settlement center "Assistance 1.1" has significantly improved the efficiency and effectiveness of the provision of services in the process of servicing insured persons under voluntary medical insurance contracts, fully complying with the principles of market development.
Thanks to the new software, it was possible to reduce administrative costs and the loss ratio of insurance events.
EuroAssistance LLC is quite cooperative with NCT and recommend it as a reliable and responsible partner.
LLC "Asistan Center "El. Ai. Si. Assistance" LLC "Asistan Center "El. Ai. Si. Assistance"
On behalf of El.Ai.S. Limited Liability Company We express our gratitude to you and your team for the high-quality development and implementation of the Automation system for operational accounting of the assistance company Assistance 1.1.
During the work, the NCT specialists demonstrated the company's customer focus, professional approach and high level of qualification. The coordinated work of the team allowed us to complete all the tasks in a short time, but with high quality and professionally, taking into account the specifics of our company.
We hope that our further cooperation will be as productive and effective.
PAT INSURANCE GROUP "TAС" PAT INSURANCE GROUP "TAС"
The management of TAC Insurance Group expresses its gratitude to you for fruitful cooperation and the creation of a modern powerful automation system for the operational accounting of the loss settlement center, which is used in the Personal Insurance Department.

High professional level of creation and wide functionality of the system were separately noted by specialists of all departments of our company. Thanks to the implementation of this software product, the Company has optimized its business processes for supporting and servicing the insured and working with partners.

Separately, we want to note the high professional level and express gratitude for cooperation, constant support of working with the system, prompt response to requests for improving the system and user training.

During the joint work, the NCT specialists demonstrated the company's customer focus and result, significant experience in the development and implementation of modern software, competence in organizational and technical issues.

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