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New for private health insurers: adesso and HMM present optimised help solution for private health insurers

The pressure to leverage competitive advantages offered by digital technology has also reached private health insurers. The provision of therapeutic appliances is increasingly becoming a key focus of attention for three reasons: 1. Rising administrative costs 2. Increasing expenditure on services 3. Lack of digital solutions to assist private health insurers with the provision of therapeutic appliances – a situation which is putting private insurees at a disadvantage compared with patients in the statutory health insurance system. Two established companies, adesso SE and HMM Deutschland GmbH, have joined forces to improve these three areas. For the first time, private health insurers will be able to digitally manage the provision of therapeutic appliances, while seamlessly integrating patients into the entire process. This is made possible by the connected IT solutions of the two companies, which enable digital end-to-end processes for insurees, service providers and private health insurers within the health promoter ecosystem.

HMM – which has over 15 years’ experience of implementing digitalisation strategies for statutory health insurers – is now expanding its proven therapeutic appliance platform ZHP.X3 to include private health insurers in a new tool called “AVIDA HiRO”. As an experienced solution provider for the insurance industry, adesso is contributing its expertise in and its knowledge of the private health insurance market. To allow adesso’s private health insurer customers to quickly and smoothly integrate this digital process for the provision of therapeutic appliances into their existing core IT systems, adesso SE will not only implement a standard interface in its core solution, but also include AVIDA HiRO in its product portfolio and actively market this new product.

The synergies of the development and project partnership are demonstrated in particular by the opportunity for private health insurers to achieve a high degree of electronic automation in their decision-making on the provision of therapeutic appliances. adesso’s experience as a developer, integration partner and process consultant for the industry opens up new opportunities for all private health insurers to support customers and their relatives in obtaining therapeutic appliances and also reduce the cost of processes and services in the insurance business.

The digital transition is leading to major simplifications for service providers: electronic prescriptions, which are scheduled to be introduced by law in 2022, are already being issued in pilot projects. AVIDA HiRO will therefore be able to provide the digital processes required when electronic prescriptions are launched, while also serving as a “fast lane” for transmitting them.

Despite a variety of tariffs and the frequent involvement of financial support agencies for civil servants, this solution gives providers of therapeutic appliances and insurees clarity at the point of sale – about personal contributions, the level of costs covered by the private health insurer and the amount of financial support.

One particular new aspect stands out: For the first time, private health insurers now have the chance to directly and digitally manage the provision of therapeutic appliances, thus changing their role from mere payers to providers of advice and support.

The AVIDA HiRO solution will also offer many additional features in an adesso app for insurees. For example, insurees will have access to continuous real-time information on the processing status of their applications and can be included in the process if necessary. In future, the entire range of services accompanying the provision of therapeutic appliances will be at their fingertips: from the initiation of repairs and replacement inspections, notification of additional needs, the extension of flat rates per case, searches for contractual partners and collection requests through to the delegation of entire processes for obtaining therapeutic appliances if insurees cannot or do not wish to handle this themselves.

adesso CEO Stefan Riedel: "The partnership between adesso and HMM is designed to enable insurers to exploit competitive advantages through digital solutions." (Photo: adesso)

“Patient empowerment and leaner, digital and largely automated processes that allow private health insurers to serve their insurees are key future topics in this changing industry. In conjunction with the relevant specialist and technical synergies, the development partnership between adesso and HMM is a powerful way of enabling insurers to leverage competitive advantages through digital technology,” said Stefan Riedel, member of the adesso SE Executive Board.

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