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Winsoft Solutions L.L.C Do i.t professionally 2002 -2014 Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved. [email protected] (+971) 4 289 69 55 Add-Vantage Insurance Management System for TPA and insurance companies (Add-Vantage - IMS) DHA & HAAD compliant

Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

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Page 1: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions L.L.CDo i.t professionally 2002 -2014

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

[email protected]

(+971) 4 289 69 55

Add-Vantage

Insurance Management System

for TPA and insurance companies

(Add-Vantage - IMS)DHA & HAAD compliant

Page 2: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Highlighted Features

Arabic, English web based portalfor all your validation

Easy payment / Pay as you go!

Multi companies support

Multi currencies support

Multi finance segments

Integrated modules

SMS & Email notification support

Integration Options Multi database support, the system

has the ability to integrate withother third party solutions

Supported databases Oracle, MSSQL Server, DB2 etc..

Add-Vantage- Insurance Management System

Page 3: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Add-Vantage –Insurance Management System

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Standard Edits (AR,CMS, AMA, etc.)

Approvals,

Helpline, CS, and

Claims

Mobile APPPortals, SMS And communication

Auto Premium

Calculation

Methods

Medical Edits Rules Engine

Network UnderwritingQuotations

ManagementSystem

Add-Vantage

PBM And more…….

Finance HR and inventory

Page 4: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

What is Add-Vantage IMS?

The Add-Vantage Insurance management system is a web based ERP

application designed to control and manage the process in insurance

companies and third party administrators, it works in modular bases which

allows the different departments to interact and meet their needs for maximum

functionality and usability

Add-Vantage has all the international aspects and configuration to match the

maximum of the clients requirements over the world, It has been built in such

way to allows you customized the functionality and the templates behind in the

way suite our valued customers needs

The major client in UAE are Neuron , NGI , Globe Med and more…

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage- Insurance Management System

Page 5: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage – Network Module

Network is a group of functionality screens which covers all the process

needed such as

Providers

Providers Contacts

Provider Billing Details

Mandatory Tariff

Provider clinicians

Providers pharmacy Tariff

Providers license

Providers reports

Providers internal codes mapping and

more…

Standard codes

Support the international coding

classifications

ICD 10CM and ICD9CM

CPT, HCPCS, DSL, ASL

and Drugs etc.. Which

match all the DHA and

HAAD

Uploading Standard Codes

Compare provider prices

and limit them to the

mandatory tariff and more…

Page 6: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage – Underwriting & Quotation Management

Underwriting is where the quotation and policies taking place in the system and

mange the CRM related details with brokers, clients and agents etc..

Agents

Brokers

Billing details

Groups

Members

Exclusions

PBM Pharmacy benefit management

integration

Edits Rules Engine integration

Finance integration

Claims integrations

And more…

Renewals

Reports

Portals for brokers, agents and

groups

Uploading Standard Codes

Premium calculation based on

reinsurer rates, fixed networks,

ages , gender etc…

Manage the pipe line quotation

and the quotation revisions

Manage the portals and portal

requests

Page 7: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage – Approvals and Helpline

Approvals and help line, The system has the ways for end user to respond for

any enquiry and have a huge criteria of search for all the modules (members,

claims, policies and reports etc…)

Search and approve any approval request Approve

Search and approve any enquiry by reference or caller information

automatically by integration with the phone system

Integration with the SMS, emails and other notifications

Search the available balances and benefits consuming before giving a new

approvals

Ability to trace the client requests and respond with the live data for claims

status and approval status enquiries because the system is linked with the

claims and other department

The integration with the finance allows the helpline to provide more accurate

and direct information to the clients

Page 8: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage – Claims & e-Claims

Approvals and help line, The system has the ways for end user to respond for

any enquiry and have a huge criteria of search for all the modules (members,

claims, policies and reports etc…)

E-claim, integration with DHA and HAAD e-claims

Paper claims

Reimbursement claims

Linked with the approvals so the system will check the claims activities

dynamically and check whether to approve it or not

Direct integration Add-Vantage medical edits engine with the eligibility and the

policies

Integration with the Add-Vantage Drubs database which is based on PBM

database check

Integration with the SMS, emails and other notifications

Productivity reports

And more…

Page 9: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage - Drug Database

Our drug data is the most extensive on the market today and includes:

Trade names, generics, herbals,

OTCs and supplements

Drug interactions checker

Drug-allergy checker

Patient education handouts

Adult dosing

Pediatric dosing

Nomenclature mapping (NDC,

SNOMED, NDDB, etc)

Warnings and alerts

Contraindications

Indications

Mechanism of action

Adverse drug reactions

Kinetics/Dynamics

Pregnancy/Lactation

Overdose Mgmt

Interactions

Trades/Cost Info

Evidence-based practice

recommendations

Nursing Considerations

Page 10: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage – Clinical Content

Our specialty-focused clinical information easily transforms any HIT system into a

comprehensive reference tool for healthcare professionals.

Disease profiles and clinical conditions

Specialized content for each department

Symptom checker

Medical calculators

Emergency protocols and algorithms

Evidence-based practice recommendations

Illustrations for patient education

Diagnostic tests

Page 11: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage –Drugs Interaction

Check for possible interactions between a patient's entire medication regime —

including prescription, OTC, herbal, supplement or foods. The most powerful

drug interaction checker available, Winsoft Solutions provides a ranked listing

of all possible interactions, and a description of each reaction.

Features:

Identify drug interactions and

minimize adverse events

Ranked by severity

Description of each interaction

No redundant information

Customized alerts

Incudes:

Drug-drug

Drug-allergy

Drug-nutrient

Drug-alternative medicine

Drug-food

Page 12: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage –Supported Countries

Our Database includes drugs from all these countries:

North America:

Canada

United States

Latin and South America:

Argentina

Brazil

Chile

Mexico

Venezuela

Middle East:

United Arab Emirates

Saudi Arabia

Turkey

Israel

Asia

India

Hong Kong

Malaysia

Singapore

Thailand

Australia:

Australia

New Zealand

Africa:

South Africa

Europe:Denmark

Finland

France Austria

Belgium

Czech Republic

Denmark

Finland

France

Germany

Greece

Hungary

Iceland

Ireland

Italy

Netherlands

Norway

Portugal

Russia

Spain

Europe:

United Kingdom

Austria

Belgium

Czech Republic

Sweden

Switzerland

Page 13: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

Per Member Or Per Claim

Contact us for presentation or proposal

Choose your comfort option and request a demo

Cloud Web Services Integration

Online Public Portal

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.

Add-Vantage –Implementation Options

Database Access / License

Page 14: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

How Can Winsoft Solutions Help?

Improving distribution management with

collaborative customer knowledge

OPERATIONAL EFFICIENCY

CUSTOMEREXPERIENCE

DISTRIBUTIONMANAGEMENT

Page 15: Winsoft Solutions L.Lwinsoftsolutions.net/Presentations/Add-VantageIMS.pdf · 2014. 11. 26. · United Arab Emirates Saudi Arabia Turkey Israel Asia India Hong Kong Malaysia Singapore

For further information please contact us

• U.A.E. Dubai

• +971 (4) 289 69 55

[email protected]

Winsoft Solutions Contact us

Winsoft Solutions. P.O. Box: 98141, Dubai, UAE. All Rights Reserved.