Know Your Member (KYM) empowers healthcare payer(s) to ensure that only the genuinely eligible members benefit from healthcare programs & initiatives. KYM gives a comprehensive picture of the member’s background, including (but not limited to) any past or ongoing law-suits, prisoner records, capital gains, dual benefits, inheritance and exceptions, thus assisting the Healthcare payers in 360-degree scanning of the case and make informed decision about beneficiary inclusion.
Allows the supervisor to consider the case analyst’ expertise, inclinations and current workload before assigning a case. Features such as linked applications, related messages & documents and recorded findings allow easy review of the case at any level in the work flow.
Enables users / analysts to securely and instantaneously share a particular section / part of the page / the entire beneficiary’s application with colleagues to record their observation with limited privileges and time-frame. Allows case workers to add their comments, make attachments and record findings right at the attribute level which can be seen / referred by all relevant stakeholders
Earmarks beneficiaries / case at the first instance of any suspicion. The Risk-radial plot (first of its kind in any of the B2B application in the world) enables the users to quickly form a constructive opinion about the case through the risk ingredients, their contributions, etc. thus revealing the beneficiary’s specific susceptibilities.
While providing a comprehensive summary of all the cases in terms of workload by age, risk event categorization and social activity, it allows the users to drill down to the last level of detail on a any specific case attribute with ease.