Connecting Providers

Expanding the pool of those who have access to healthcare starts with connecting those who need to provide the care with each order, providing better and affordable ways to pay for care.    Also creating an environment that lets those who seek care have access to all providers  at a fair comparable cost helps the overall outcome of care delivery.   Payments, documentation, claims, capitation, enrollments, patient records and referrals are managed in realtime with all parties transparently interacting with better productivity and at lower a cost.  

 

Helping providers improve care delivery is rooted in managing cost, ensuring timely payment for services, and flexible access to data that can be shared between providers.    We connect critical stake holders in the healthcare system to enable seamless data sharing, electronic payments, rules and digital care contracts.  

 

Starting with insurance enrollments to field operations, our solutions cover a range of stake holders in the ecosystem while making sure the financial flows, care delivery and payments for services rendered can be effectively managed on a platform that lets providers focus on delivering care and not paperwork or data management.

Image by Hush Naidoo
chc-modules.png

Who We Connect

Central to the platform is the ability to connect all stake holders in the healthcare ecosystem with a goal of distributed collaboration, management of compliance, cost reduction, seamless payments and ultimately improving patient outcomes.   CIMPLE provides an array of applications, web portals and integrations for providers to harness existing solutions and systems or start afresh.

 
Surgeons in Operating Room

Insurance / HMOs

Insurance providers get access to a broader population of beneficiaries by offering a range of coverage products that allow more people to participate in insurance, with flexible payment and collection methods that are suitable for the formal and informal sectors.     Also the management of a diverse population with insurance coverage becomes  when as providers can seamless manage claims with hospitals and clinics, negotiate pricing, and enroll beneficiary without the traditional costs.    The following are key benefits to insurance providers:

 

  • Direct Enrollment (from your website)

  • Field Enrollment (via Field Health Agents)

  • Paperless Claims Management 

  • Provider Invoicing / Billing / Payment

  • Co-Payments of Premiums

  • Field Premium Collection / Micro Collections

 

Hospitals / Clinics

Health Providers that operate hospitals and clinics can accept patients are sponsored, direct-pay, or with insurance coverage without the complication of billing, paperwork, payments, and maintaining health records that is accessible by insurance, the hospital and the patient.     Operationally, providers can use CIMPLE to manage all interactions not just with patients but with insurance providers and sponsors to reduce the overhead and cost of providing care.   Here are some benefits for providers:

 

  • Insured & Direct Pay Patients

  • Online payments & Cash

  • Co-payments of any invoice by loved ones 

  • Realtime Insurance verification 

  • Claims Submission &  Payments Management

  • Electronic Health Record Management

  • Sponsored Services

  • Referral Management

Young Male Nurse
 
Female Pharmacist

Pharmacies

Operators of pharmacies can electronically receive patient prescriptions from hospitals and clinics, while accepting payments or co-payments from insurance and patient sponsors for drugs covered under a plan or sponsorship rules (for example via as a Pharmaceutical company).     Pharmacies can also accept online payments for from the diaspora for over counter drugs and precriptions for loved ones.   Here are some benefits for:

 

  • Accept Online Payments 

  • Drug/Prescription Delivery (via Health Agents)

  • Online Prescription Records Management 

  • Insurance & Sponsor Drug Co-Pay

 

Public Health Schemes

Managing public health schemes for large populations can be challenging when it comes to insurance, decentralized field enrollments, and providing care to the most vulnerable.   CIMPLE orchestras this process by making it easier for health officials to connect critical parties in the health ecosystem and work together in covering all beneficiaries with adequate insurance and getting good care.   In addition, there is the flexibility for public health schemes to either provide Insurance directly or provide coverage through existing HMOs and insurance provides or a hybrid of both models.   What ever the case, it is possible to manage very large public health schemes with following benefits:

 

  • Decentralized field enrollments (via Health Agents)

  • Premium Collections 

  • Microcollections (for the the informal sector)

  • Offer Group, Unions, and Coorpoerative Health Plans 

  • Utilize Existing HMOs as “Proxy Insurance” Providers 

  • Diaspora Sponsorhip of Programs

  • Direct Online Payments and Co-Payments

clinic-1.jpg
 
kids.jpg

NGOs & Charities

For NGOs and Charities with a goal of providing health care and education services,  your organization can offer its services and receive compensation from sponsors and other forms of payment for your services on a Per-Beneficiary-Basis with better transparency and records management with donors.    Also with the network of sponsors on the CIMPLE platform, NGOs and Charities have access to funding based on real-time qualification rules for eligible beneficiaries.   For example, an NGO that provide service to on reproductive education and practices can access Pay-Per-Beneficiary (PPB) funding rules by sponsors for women in a particular age range, geographic location and circumstances.   Additional benefits are:

 

  • Greater Access to Funding for Services

  • Accept Insurance Plans for Services

  • Expand Services Provider

  • Donor-Matched Payments For Services

 

Field Health Operators

Mobile Health & Field Service providers can offer their services to insurance, hospitals, and clinics where the flexibility of field mobility is required.   This improves the outreach to patients and beneficiaries greatly at a lower cost that brings more people into the healthcare coverage ecosystem.    Qualified and approved operators of field services can use CIMPLEs platform to provide services on behalf of any insurance, hospital or clinic with direct agreements with such providers.   As a field operator the following services can be provided to beneficiaries.

 

  • Field Enrollments to Insurance Plans & Public Schemes

  • Payment Collections & Micro Collections

  • Clinical Field Data Capture

  • Paid Home Health Visits & Checkups

  • Paid Clinical Followups

clinic-2.jpg
public-healt-1.jpg

Public Health Agencies

Federal, State and Local Public health officials need ongoing and access to healthcare information for the management and monitoring of operators and care providers.   CIMPLE provides multiple levels of integration, portal dashboards, controls and data feeds that enable public health officials to carry out quality health delivery enforcement.

An example of an integration, is the automatic registry of births and deaths of lives in the public registry that allow digital certificates to be issued by hospitals or field service providers from a mobile phone, without the need for any paperwork.    Others features provided to health agencies are:

  • Control of Read/Write to Public Data Registries

  • Monitoring of Health Performance Indicators

  • Mass Communications to Healthcare Providers

  • Operational Audits of Patient Records

  • Compliance Management

  • Complaint Management

  • Electronic Certificate Issuance