Sumex Outpatient Flat Rates Expert: Review, simulate, document
Review outpatient flat rates directly, soundly and traceably – for all insurers, with or without the Sumex Suite
With the Sumex Outpatient Flat Rates Expert, insurers recreate invoices containing outpatient flat rates in Sumex's own grouper and simulate adjustments. Every result and every simulation is recorded directly in the case.
Less manual work in the review
Until now, insurers had to turn to public web services to review outpatient flat rates. That meant leaving their own system, re-entering data and transferring the result back by hand.
The Expert brings the core functions of these services into your own review process. Sumex Suite customers no longer need to switch between systems.
Recreate invoices and simulate variants
The Expert shows at a glance where an invoice is unusual and what cost impact results. Outpatient flat rates and services can be adjusted, and every variant is compared with the base case before a decision is made.
New tariff versions are updated automatically, so reviews always use current tariff data.
Every decision stays traceable
Simulations and case comments remain stored with the case. Anyone who reopens the case finds the same status, even if someone else has taken over in the meantime. Cases can also be exported.
For all insurers – with or without the Sumex Suite
The Expert is web-based, requires no installation and is quick to learn thanks to its intuitive operation. For customers with the Sumex Suite, one click from the case is enough, and the invoice data is transferred automatically. Insurers without the Sumex Suite open the Expert in the browser, enter cases from scratch or import invoices in XML format.
Reviewing outpatient flat rates must be simple and traceable for insurers. With the Outpatient Flat Rates Expert, that works whether they use the Sumex Suite or not.
Felix Musterle, CEO, Sumex AG
Process view
Outpatient Flat Rates Expert
Experience the Sumex Outpatient Flat Rates Expert live
We would be happy to show you in a demo how the Outpatient Flat Rates Expert fits into your review process. Contact us via our contact form.