TCS BaNCS for Health Insurance

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TCS BaNCS for Health Insurance, powered by APIs and delivered on the cloud, is a complete solution suite, supporting a range of both individual and corporate products. It encompasses customer onboarding, member enrollment, product configuration, rules management, plan management, policy administration/endorsements, pre-auth and claims management, network Management & service provider onboarding including contract Management, Insurance accounting ,re-insurance and EDI for e-Claims processing. All of the above components are Modular & Micro-service enabled. The entire suite includes Intelligent Experience Centre for Front office users like Customers, Intermediaries and Other Third Parties , Digital Contact Centre for middle Office users and Digital Service Centre for back office users. It includes innovation and low touch experience powered by chat bot, Voice enablement, Alexa integration and AI/ML driven processing. The solution is enabled with multi entity, multi language and multi currency support. It follows open architecture with Restful APIs which is cloud agnostic and devOps enabled.

Key Features

Product and plan management enabling quick time to market by configuring new products and plans from UI. In-built Rules management and in-built tool for Workflow configuration. CRM enabling smooth customer onboarding and providing a customer 360 view. Provider and network management enabling smooth provider onboarding along with contract management and provider analytics. Separate module catering to EDI. Underwriting workbench for member level undewriting. Automated claim adjudication supporting E-claims and E-Pre-authorization for Claims processing.

Key Benefits

SaaS-based cloud-agnostic offering based on microservice and cloud-native architecture:

- providing our customers elasticity and flexibility to adapt based on workload changes

- and offering value in terms of redundancy

Tailored solution options - customers can opt for full functional coverage (all components), or select components and microservices-based implementation options for immediate realization of invesments.

Customers can launch new products and achieve superior speed to market with the help of various out-of-box features, such as a comprehensive rule engine and tools for migration and product cloning. Reusable libraries of geography-specific product templates, tariffs and reports aids in faster product launches.

Large repository of APIs covering over 90% of the product features being exposed as APIs. More than 1500 APIs are published on TCS BaNCS Marketplace, whereby customers and innovation partners can create integrated solutions and get the benefit of larger connected ecosystems.

Customers can achieve greater operational efficiency, automation and channel integration with the help of AI-driven low-touch user journeys leveraging NLP, Visual Computing, IOT, Data Analytics, etc., most available out-of-box or via integration with BaNCS Insurance Ecosystem Partners.

Digital offerings to cater to various players in the ecosystem, eg: customer, advisor, surveyor, operations, managers, etc.