National Health -Iraq

We have a unique system for premium collection, revenue management, membership identification, admittance and claim certification for the health industry .The system was designed to provide security in identifying the rightful medical contribution payment owner as well as help eliminate fraud in the system. This system will dramatically reduce the existing administration and operational costs involved in the collection of contribution, payment of medical benefits and reporting of all activities.
This solution is built upon U.E.P.S. Technology (Universal Electronic payment system) which makes use of smart card technology using biometric fingerprint as the method of identification. The three U.E.P.S. products utilized are:-
• (Smart Card to Smart Card) Registration, Enrolment & Smart Card issuing.
• Premium Collection.
• (Smart Card to Smart card) payment system.
To participate in the system employers and members need to be registered on the system host and issued with smart cards . At the time of registration the fingerprint of the member , the spouse and up to 8 dependant s can be stored on the card for on-site fingerprint identification.
All Healthcare service providers will need to be registered onto the System Host and issued with a merchant card. Each with a merchant Reference Number (MRN).
COLLECTION OF CONTRIBUTIONS
All employers have their payroll operator’s PC equipped with a Smart Card Reader, an employer operator card and the necessary Premium Collection Software Application, This application imports a simple export data-file from the payroll package containing the member’s name, USN Smart Card number, the amount of the premium and the data of payment. This file is sent to the system Host for processing and the employer deposit the actual monies due, in respect of the total premium contribution collection into a nominated bank account of the system Host. Once payment has been confirmed, encrypted codes for the premium contributions and data of payment are created and stored on system host. These signatures need only be updated to the smart card when medical assistance is required by the member or his/her dependents.
The fund contribution totals for the day will be processed at settlement each evening and paid into a nominated bank account of the healthcare found.
When a member is admitted into hospital, proof of membership will be required by presenting their smart card on admittance. The member’s signature (contributions) needs to be updated utilizing the following methods:
ONLINE UPDATE
- Utilizing the POS terminal connected to the Smart Switch infrastructure, after biometric fingerprint identification, the member will select the “Online Premium Update”.
- The signature can only be written to the card if all monthly contributions are up to data. If in not, the smart card will not be updated.
OFFLINE UPDATE
- The “Contribution Encrypted Signature “ codes generated by Smart Switch , are submitted electronically to the employer concerned for printing out and handing them out to the individual cardholders .
- The “Contribution Encrypted Signature “ codes generated by Smart Switch on receiving the contribution payments ,can be submitted electronically to National Health Fund head office to distribute to update his/her contributions.
On confirmation the member will be prompted to present one of their fingerprints for verification purposes .The system will automatically record the data ,time ,patient information and hospital details on the merchant card as well as the member’s card .When the patient is discharged the smart card is presented and the check- out time is written to the merchant card as well as to the member’s card .The final amount for the hospitalization period is entered and biometrically identified by the healthcare worker and patient .The merchant card is settled daily to the system Host.
MIS reports are issued to the Healthcare Fund by the switch detailing the fallowing:
- Monthly member contribution reports.
- Monthly exception reports for members in arrears.
- Monthly report showing card hot-listed.
- Monthly report showing cancelled card.
- Daily reports showing “Check-ins” and “Check-outs” at the various hospitals.
- Daily reports showing new member enrolments with beneficiary details
http://www.smartqi.com/ISC_en/index.php?option=com_content&view=article&id=121&Itemid=126