Insurance and Claims Management


Insurance firms and TPA’s are growing & changing in-line with their domain requirements. It also means they need to be technically equipped to manage their operations efficiently and in accordance with the rules, regulations & compliances applicable.

Automated claims processing through specialized software takes care of a lot of documentation issues and provide error-free results.

Further, many insurance firms are trying to satisfy emerging consumer expectations but lack flexibility to rapidly incorporate piecemeal elements to their current offerings/activities. Businesses compete & win on account of their reach through digital technology and our Insurance & Claim management module is here to solve this challenge.

We provide technology and cost management services for insurance providers, third party administrators and government agencies. Through our Insurance & Claim Processing solution, we are able to apply the most effective approaches to the claim management needs, considering the dynamic complexities of controlling claims costs without compromising on the quality of treatment.

Our software functions alongside the existing claims management process & allows insurance firms to easily resolve new business needs.

  • E-Insurance Claim Processing
  • Quick Insurance Claim Process
  • Insurance Claim Forms
  • Transparent Claim Processing with Compliance

SERVICES - Software Modules

Utilization Management:

eHealthflex’s Utilization analysis solution provides Potential analysis, Coexisting analysis, Retrospective analysis, Drug utilization analysis of all the Medical Requirements. Our Utilization Management services module promote timely and effective care of injured workers while providing employers with improved financial controls. Read More….

Case Management Module

Our cellular and field-based case management systems offer cost-effective evidence-based solutions that avoid excessive and inadequate medication. Treatment is handled proactively on the basis of rules and evidence-based guidance intended to facilitate rehabilitation and reduce costs and to comply with jurisdictional regulations. With this software, we aim to provide an effective way of managing the coordination of medical care & recovery and fulfil the return-to-work objectives. Read More….

Bill Analysis Module

Our software can help to process Worker’s ' compensation or multiline expenses. We utilize advance technology, which can be used along with highly trained medical experts and skilled nurses to review medical expenses. Bill analysis services can be streamlined for any regional or national network. Maximum savings are achieved by steps including the implementation of fee schedules and billing. Read More….

Professional Health Assessment Module

We seek to include unbiased expert advice about your accident or medical condition that are straightforward, succinct and reliable. Our software offers Comprehensive Patient Assessments, Practical Ability Tests, Medical Record Reviews and Occupational Health Services. With this solution, Medical Examiners can provide their expertise and assistance to help clients acquire specialist, accurate health advice on the most challenging claims. We have a huge variety of convenient-to-use solutions that satisfy your specific requirements, irrespective of the quality and geographical coverage of your claims.

Peer Review Module

We provide platform for you to register your Credentialed & Licensed Physicians that are skilled with evidence-based procedures and are actively engaged in the medical profession. With this, our effort is to provide reliable, evidence-based evaluation services resulting in a factual output that can be defended at any point.

Pharmacy Review Module

Our prescription review system efficiently integrate the reports and drug or medication analysis process, allowing you to make a participant pharmacy benefit decision with consistency, objectivity, precision and timeliness. Overuse of drugs can impair the well-being of patients. The evaluations of Pharmacy take into account the quality, use and suitability of medicines within the framework of the care program. With all the additional modules, we strive to deliver appropriate medical resolution in the claim management process. Through our timely & conclusive review system, which helps in providing for a defensible and evidence-based consultation, it addresses the medical necessity and appropriateness of care.