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OUT-PATIENT BENEFITS MANAGEMENT (OBM)

Subtitle: 

Out-Patient Benefits Management (OBM)

abstract: 

GlobeMed’s Out-Patient Benefits Management (OBM) solution combines a state-of-the-art IT platform, industry know-how and best practices to effectively manage payers’ out-patient benefits plans and improve members’ experience, while controlling costs. 

 

GlobeMed’s Out-Patient Benefits Management (OBM) solution combines a state-of-the-art IT platform, industry know-how and best practices to effectively manage payers’ out-patient benefits plans and improve members’ experience, while controlling costs. Our OBM can be integrated within GlobeMed’s full TPA services or offered as a standalone solution for risk carriers.

 

Out-Patient care covers a wide range of medical services and procedures conducted on an outpatient basis in clinics, diagnostic centers, dental clinics, optical centers, etc. Out-Patient procedures include lab tests, radiology, physiotherapy, doctor consultations, optical and dental services and much more.

 

The key features of the OBM are:

• Benefit Design Options

• Members' Administration

• Network Management

• Online Eligibility/Automated Prior Authorization/Claims Submission

• Advanced Expert System

• Analytics, Business Intelligence & Reporting

 

Furthermore, GlobeMed’s expert system, ARC, checks out-patient claims against the automated medical rules and coding edits to identify any potential problem while rendering ambulatory services. It is based on well renowned databases and dictionaries including a standard medical dictionary based on medical necessity rules, coding edits dictionary and a medico-administrative dictionary for the rules related to policy benefits and restrictions.

download our brochure: 
application/pdf iconobm_brochure_20-12-16.pdf
OUT-PATIENT BENEFITS MANAGEMENT (OBM)

GlobeMed’s Out-Patient Benefits Management (OBM) solution combines a state-of-the-art IT platform, industry know-how and best practices to effectively manage payers’ out-patient benefits plans and improve members’ experience, while controlling costs. 

PORTAL PER POSITION

The Portal per Position Project is about managing workstation processes based on a set of parameters that include the job function, position, department & type of organization.

PUMA (Production Underwriting Monitoring Analysis)

GlobeMed innovative web-based solution PUMA comprises 5 modules:

HEALTHCARE BENEFITS MANAGEMENT

GlobeMed offers franchisees the tools and expertise

PHARMACY BENEFITS MANAGEMENT

The standalone Pharmacy Benefits Management (PBM) solution built by GlobeMed is a core set of tools designed to manage the cost and use of prescription drugs

CODING TRAINING PROGRAM
PHARMACY MANAGEMENT SYSTEM

Pharmacy management systems help pharmacies streamline their workflow thus delivering better care through a more efficient, automated process...

MANAGEMENT OF PRIMARY AND DENTAL CARE CLINICS

Recognizing the importance of primary care in improving health outcomes and managing costs...

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