Upgrade/Modernization of the Contract & Case Management (CCM) System – CCMSoft development for the private insurance company

A private insurance company JSC Archimedes Global Georgia (AGG) contracted CGC to upgrade CCM Soft for contract and case management system introduced a year earlier.

The purpose of the assignment was to accelerate introduction and development of modern technological approaches and management practice necessary to ensure efficient and effective delivery of quality services to meet rapidly increasing demand.

Actual services provided

  • Strengthening of general management practices and improvement of the performance of middle-level management;
  • Standardize insurance products for corporate and individual clients and establish flexible and efficient interface between sales and core internal operations (including actuarial analysis and customer satisfaction monitoring;
  • Establish health care provider (HCP) network management system including retrospective and concurrent case management systems to minimize unjustified utilization and corresponding losses and ensure quality and satisfaction with medical services;
  • Introduce basics of a quality assurance/management mechanisms with emphasis on comprehensive customer satisfaction monitoring system;
  • Introduce more advanced authorization and claim processing techniques and procedures;
  • Increase the capacity to meet reporting requirements of key stakeholders, including the Financial Monitoring Service, the Ministry of Labor, Health, and Social Affairs, etc.
  • Upgrade the CCMSoft to meet the needs of the management and technological processes.

Within the consultancy services following products have been delivered:

  1. Consolidated performance reports (by months and by dates);
  2. Module for the management of reserved policies and lists of insured;
  3. Limits per family for specific contracts and/or packages;
  4. Triangulation report;
  5. Client specific claim processing and reporting module.