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OUTPUT PROCESS
The output process as a chain could be divided in three THE HEALTH INSURER
segments. Combining customer service and accuracy should be the
main focus in the health insurer’s correspondence.
Personalized mail and specifications contain financial and
Input data medical data, therefore accuracy of the information shown
The chain’s input data is being generated by the back office is essential. Customer service is one of the primary aspects
application(s) and holds a selection of the information on which a health insurer distinguishes itself from the
needed to determine most of the variables in the process. competition.
XML is currently the industry’s leading standard data format.
Multiple data sources could possibly be used to deliver all A health insurer communicates with numerous parties:
necessary information. insured clients, collectivities, care providers and the
government. Despite the health insurer’s innovative
attitude, an inevitable, extensive physical output flow
Document generation remains. Paper documents are and will be the company’s
Once the input data has been read into the OutputManager, ‘business card’.
the correct template will be linked. Specific, possibly
adjusted, data elements will be used to show different
variables within the template. Clients
The most important output flow towards the clients
remains paper documents. Each year, this target group
Output receives ‘high volume’-documents (for instance the annual
The OutputManager combines the input data and template to policy, payment specifications, medical approvals) and ‘low
generate output. The output will be available in different volume’-documents (irregular letters and forms, ad hoc
formats, depending on the distribution channel(s). correspondence). Standardization is in both cases
important to keep the company’s house-style recognizable
with its clients.
Collectivities
Health insurers have a great commercial interest in a flexible
attitude towards collectivities. These parties often represent a
large number of insured clients, but unfortunately use diverse
administrative processes. Technical limitations regarding
mutual information exchange creates a potential risk for the
relationship with the collectivity.
OUTPUTMANAGER
The health insurer’s OutputManager should be able to
generate output batch wise, ad hoc and interactively.
Health care providers
House style documents containing the right data will be
General agreements between health insurers and health care
distributed via the chosen channel. More than other
providers stimulate standardization of information exchange
organizations, the health insurer is offered the utmost
and quality of information privacy. Digital distribution channels
flexibility in document composition and data integration.
have taken a prominent role in the financial output process;
conformance is necessary.
Document Composition
Alongside this digital message exchange, the paper document
Numerous OutputManagers offer extensive possibilities in
flow mainly consists of medical approvals. Health records’
composing documents. A WYSIWYG (What You See Is
sensitivity and legal aspects are causing a slow movement
What You Get) -interface is the key feature to introduce
from paper to digital.
document composition to users, so they will be able to
rapidly develop templates on their own.
Government
The interface allows the user to develop the template and
Government institutions wish to periodically receive data from
combine it with the necessary input data. Since the input
the health insurer. Distribution takes place digitally, through
data is generally in XML format, defining Xpath queries is
several channels, and on paper.
another key feature.
Intelligent Forms
In scheme: Health insurers aim at providing self-regulating
mechanisms for external parties to reduce overhead costs.
Clients are able to execute policy mutations and request
information online. These services are very popular and
health insurers can’t do without. But unfortunately, the
technical realization often consists of actions foreign to the
back office application and therefore results in a difficult-
to-manage process.
TRUSTON
Truston is an ICT service provider with a focus on ICT
services for health insurers and managing information
systems and Truston is Oracle Certified Advantage Partner
as well as Microsoft Certified Partner. With its expertise,
technical skills, products and services, Truston offers an
indispensable contribution to the success of its clients and
is proactively involved in development.