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Eicore's HealthBuzz: Revolutionizing Health Insurance Management

By: Gopal Verma | Friday, 20 October 2023

Technology is pivotal in shaping the modern insurance landscape. With over three decades of experience in the insurance industry, I've observed how legacy systems can impede progress. This drove me to found Eicore, dedicated to insurance management software, with the aim of breaking these obstacles and introducing agility and efficiency.

In the ever-expanding health insurance sector, insurers are now compelled to seek software solutions that are not only efficient but also agile. However, given the intricate landscape of health insurance, legacy systems have proven inadequate in swiftly adapting to evolving business demands.

In this context, Eicore products stands as a testament to overcoming these inherent challenges, which ultimately became the driving force behind Eicore's unique selling point.

Some of the key elements that our Health Insurance Management System, HealthBuzz, addresses include:

  • Complexity of Plans: In the realm of health insurance, complexities abound, particularly in plan management. The variety of plan options with differing coverage, deductibles, co-pays, and customised provider networks demands deft handling. Eicore’s HealthBuzz recognised the significance of this aspect, leading to user-friendly plan management for insurers and their clients, including corporate clients as well.

  • Regulatory Compliances: The domain of health insurance is rife with regulatory nuances, subject to stringent oversight by Insurance Regulators and government bodies. Real-time data acquisition and submissions emerge as critical components of compliance. In response, Eicore developed a robust system capable of seamless data exchange, bridging the gap left by legacy systems.

  • Data Security: Safeguarding sensitive personal and medical data has become paramount in today's data-driven environment. Here, Eicore took a proactive stance, ensuring data security and privacy.

  • Integration: The integration imperative stands out as a pivotal challenge. The complex web of relationships with various entities, such as aggregators, payment gateways, insurance companies, other systems, wellness platforms, third-party applications, and regulatory bodies, demands seamless integration. Eicore's forward-looking approach addresses this aspect seamlessly.

  • Geographical Focus Products: The increased need of insurers to introduce geographical focus products, keeping in mind the differences in the cost of healthcare expenses in Tier-A, Tier-B, and Tier-C cities. This necessitates the system’s capabilities to underwrite and issue policy documents with various permutations and combinations, making it even more complex to administer benefits for such products.This is the unique capability of Eicore’s HealthBuzz System.

  • Management of OPD Products / Benefits: Some markets, especially in India, have not yet witnessed genuine OPD products for various reasons, e.g., lack of data and absence of health regulations. The issue of “lack of data” can be addressed by an efficient Health Insurance System. Eicore’s HealthBuzz has proved its capabilities in managing OPD Health Insurance Benefits in some of the developed markets from the OPD benefits perspective.

  • Product Configuration: The unique feature of Eicore’s HealthBuzz empowers users to configure benefits, premium rates, specific provider networks and other functionalities from the front end. Insurers using legacy systems are heavily dependent on change requests from system providers, which is a time-and cost-consuming factor.

  • Member Enrolment: Bulk enrolment has been a major challenge for legacy systems. The unique interface of Eicore’s HealthBuzz, coupled with its employee’s portal, unburdens insurers and corporations from this laborious function through its user-friendly interface with multiple options, including but not limited to bulk uploads, employee/employer portal.

  • Eligibility Management: Navigating the complexities of enrolment, eligibility, and employee status changes, particularly in larger organisations, posed a significant hurdle. Recognising the need for dynamic and accurate insurance product benefit and pricing capabilities, Eicore has simplified the management of complex functions, both from underwriting and benefit administration aspects, in its HealthBuzz system.

  • User Experience: In the realm of user experience, Eicore Solutions honed in on the importance of delivering a seamless experience to both employers and employees. Unfriendly interfaces can lead to frustration, errors, and lost renewals—a situation deftly avoided through Eicore's approach.

  • Premium Calculations: The intricacies of billing and premium calculations, especially in dynamic scenarios, necessitate flexibility. Eicore systems were architected to handle diverse billing cycles and complex employer/employee scenarios.

  • Claim Processing: The efficacy of claims processing hinges on precise benefit configuration—a challenge unmet by legacy systems. Eicore addressed this shortcoming head-on, ensuring accurate claims handling and preventing financial leakages.

  • Communication: Effective communication and user support form the bedrock of user satisfaction. Eicore prioritized these aspects, establishing a solid foundation of trust and contentment among users, keeping in mind the ever-changing scenario in customer communication modes, including conventional mailing, SMS, email, WhatsApp, and mobile app notifications.

  • Scalability: As enterprises grow, the scalability of systems becomes non-negotiable. Eicore recognised this necessity, building scalable health insurance systems that can evolve in tandem with business growth.

  • Customisation: In the realm of customisation, where unique employer requirements take center stage, Eicore HealthBuzz flexibility shines. The rigid confines of legacy systems were replaced with adaptable architectures, catering to the diverse needs of employers.

  • Re-insurance Module: The growing demand for high sum insurance cases and high claims ratios necessitates insurers to seek re-insurance support in various forms, including but not limited to EOL and facultative reinsurance. This makes it necessary for insurers to have a dynamic re-insurance module. Eicore’s HealthBuzz has been designed to address this very need in the health insurance business.

Overcoming the technical challenges that underpin modern insurance systems is no small feat. Eicore’s continuous commitment to technical expertise, updates, and maintenance ensured its systems remained agile and responsive.

Written by Gopal Verma

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