How Hallmark HMO fully digitised their Claims Processing
Use Case for top African Health Insurer
Hallmark HMO is a leading health insurance company in Nigeria born out of the need for quality health maintenance services. They have a mission to provide quality health maintenance services and bring the best health care insurance to the general public. Hallmark HMO is one of Curacel’s very first clients and they have stayed with us ever since.
Challenge: Claims Processing
Claims processing constitutes the biggest challenge to Health Insurers around Africa, with the manual processing of Claims still the norm for most insurers. For the insurers with a collection system, most healthcare Providers have challenges using those systems due to their complex nature. There is also the challenge where different insurers have their own system in place causing healthcare Providers to learn to use multiple platforms for the same task.
Solution: Curacel Claims Automation
Hallmark HMO previously had all their claims processed manually before Curacel came into the picture. Since 2019, Hallmark HMO has used the Curacel Claims portal to handle their entire claims processing – including claims collection from their providers, tariff management, Provider management, claims adjudication, authorization management, enrollee management and payment management – with more than N128 million in claims processed from 628 Providers.
Thanks to Curacel and her technology, Hallmark HMO’s providers find it easy to submit claims in real-time and Hallmark HMO can handle the processing in real-time as well, leading to very fast claims turnaround and settlement, which is a delight for Hallmark HMO, her providers and her clients.
“Our entire Claims process received a huge boost with Curacel. Our backlogs of claims are reduced and we are more efficient as a company. Best decision we have made so far!” – Dr. Frank Ekhalufoh, Head, Operations, Hallmark Health.
Curacel is an insurtech company, building solutions that enable insurance companies to effectively and efficiently process claims faster, detect fraud early and for better insurance distribution.