Systems of integrated health insurance processes management: analysis and application in Greece

Abstract

In this paper it is described the development of an Information System (manage care) that utilizes advanced Information Systems and Communications technology and its operation serves the collection, recording and processing of health care services consumption data, under Private health insurance plans. Manage care was designed in such a manner, in order to -either func¬tioning as an independent system, or included in an integrated information system of an Insur¬ance Company- support all processes, applied in modern systems of managed care organizations, but also to standardize the way of recording and follow-up of insurance and health care services consumption data. The development of manage care was mainly dictated by the fact that, as it was also realized by the present research, the insurance companies in Greece, still do not have any essential intervention and control over health care services cost. The integration of Manage Care was also accompanied by proposals that materialize its evolution also as supporting mana¬gerial tool, with the use of state-of the-art technology and its successfully adaptation in managed care organizations and health insurance companies.