- About jalma
Partners
Meet our partners.
News
Our latest news and press publications.
Team
The largest team of social protection and personal insurance consultants.
Corporate culture
Our values and strengths.
Key Figures
Our company in a nutshell.
- Our area of expertise
- OUR HEALTHCARE CONTENT
- Our experteo© solution
Estimate analysis
experteo © advisory, control and automization modules.
PRACTITIONER AFFILIATION & THIRD PARTY PAYMENT
experteo © modules for management of health provider affiliations and third party payment.
- Our publications
White papers
Read our White papers for a better grasp of future changes in health insurance.
Surveys
A statistically detailed view of the market.
Health insurance panoramas
Our Panoramas seek to examine current changes in social welfare and innovations in personal insurance.
Health and Ageing Survey
Consequences of ageing on our healthcare system.
- Careers
Our core business
Everything you want to know about jalma.
Join our team
Become a consultant at jalma.
Our vacancies
Job and internship opportunities.
Apply
Would you like to join us? Send us an application.
PRACTITIONER AFFILIATION & THIRD PARTY PAYMENT
PRACTITIONER AFFILIATION MANAGEMENT
The practitioner affiliation module is fully integrated in the file management process and is linked to payment management based on :
- Affiliation management rules (frequency, healthcare providers, price matrices,…)
- Network management
- Affiliation rules are taken into consideration for in the computation of complementary reimbursements, control processes and advisory services
- Referring client to visit affiliated healthcare providers
THIRD PARTY PAYMENT
This module consists of five functions :
- Transformation of estimates into coverage claims and invoice
- Definition of coverage claim acceptance regulations
- Delivery of a claim approval
- Availability of online coverage claim processing
- Electronic data exchange and analysis for optical equipment (DEVPEC and OPTOAMC standards)
