The National Health Insurance Fund (NHIF) is a state health insurance fund that ensures that health care and medical treatment costs, as well as reimbursement medicines and medical equipment are paid for everyone covered by public health insurance. In the case of reimbursement, the payment of medical equipment must be managed in a transparent and accurate manner, and timely information must be provided to all participants in the process: the patient, the medical institution, the National Health Insurance Fund, and the medical device suppliers. It is also necessary to ensure that reimbursement is awarded in accordance with the rules and regulations. InnoForce has developed a Queue Management Information System, QMIS, which automates and integrates processes involving the NHIF, personal health care facilities and patients, ensuring transparent and accurate decisions on the distribution of medical aids, medicines and reimbursement.
QMIS is an electronic service system that enables to provide current information in real time to each of the participants in the process electronically, and provides a quick, simple and reliable form of communication between NHIF, patients (regardless of the patient’s place of residence) and related treatment facilities.
QMIS has automated procedures for exchanging information with other NHIF systems (Document Management, Compulsory Health Insurance Register, Financial Management and Accounting, etc.) at specified intervals or over time, and fulfills tasks to ensure prompt and transparent queuing and reimbursement activities without human intervention.
QMIS helps to ensure that processes comply with the requirements of regulations and legislation, as the solutions implemented are capable to check whether e.g. the doctor prescribing a procedure, reimbursement or surgery has a relevant license, or whether the medical institution has not exceeded the limits, etc.
Patients can keep track of their condition, time, reminders and exchange information with medical institutions and the NHIF online. During the project, development of system functions, modification of existing functions, continuous operation of the system was performed.