Medical Benefit PlansPlan setup, categories, coverage, and effective dates.
Benefit CategoriesOutpatient, inpatient, dental, optical, specialist, and prescription coverage.
EligibilityEmployee and dependent eligibility management.
Medical ProvidersHospitals, clinics, doctors, locations, and provider status.
Benefit LimitsAnnual, per-visit, service, employee, and dependent limits.
Benefit BalancesTrack remaining benefit amounts and utilization.
Medical ClaimsSubmission, status, history, and claim processing.
Claim ValidationPolicy, limit, eligibility, duplicate, and document checks.
Claim ApprovalsHR, manager, medical administrator, and finance workflows.
ReimbursementsApproved amounts, payment references, and reimbursement history.
Medical DocumentsReceipts, invoices, doctor documents, certificates, and attachments.
Digital Benefit CardsEmployee and dependent identification with benefit information.
Employee Self ServiceBenefit visibility, balances, dependents, claims, and history.
NotificationsClaim, approval, reimbursement, expiry, and limit alerts.
Medical DashboardsCentralized operational and management visibility.
Reports & AnalyticsUtilization, healthcare costs, claims, provider performance, and trends.
Audit HistoryTrack important changes and benefit administration activity.