Claims handling with Rule Engine

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Rule Engine - Munich Re

Rule Engine

The golden rule in claims handling

Globally, as much as 10% of all medical expenses are the result of overpayment, fraud and abuse. Up to now, detection of incorrect billing has been complex and time-consuming. The Rule Engine is a computer-based service that not only supports your claims adjudicators, but also enables you to fully automate claims handling. Drawing on the experience of the worldwide Munich Health network of physicians and backed by official medical guidelines such as the British Medical Journal, the Rule Engine guarantees high quality standards.

Good reasons to implement the Munich Health Rule Engine

Solid foundation

  • Reliable medical evaluations based on the know-how and experience of the worldwide Munich
  • Health network of physicians and backed by official medical guidelines such as the British Medical Journal

 

Efficiency and cost-effectiveness

  • Substantial cost-saving opportunities on both medical and operational expenses
  • Improved speed and transparency in claims handling
  • High performance: automatic processing of 50,000 claims per day or more

 

Flexibility

  • Integration into your existing claims process
  • Knowledge base and rule set adjusted to your specific market and company requirements
  • Implemented in various grades, from claims evaluation support to a fully automated version

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This publication is available exclusively to Munich Re clients. Please contact your Client Manager.