PROJECT OVERVIEW

The Provider Payment System developed by Tecnova for Isapre Banmédica enables healthcare providers to submit claims for voucher payments through a web-based platform. These services correspond to medical care delivered by healthcare institutions to members enrolled in Banmédica’s health plans.

The primary objective of the project was to automate the previously manual processes for payment claim submissions, which at the time required in-person processing at Banmédica branches. To address this, the project focused on delivering a platform that provides greater autonomy to healthcare providers, allowing them to internalize and manage the payment request process independently.

As a result, the solution significantly reduced the operational workload at Banmédica branches, generating substantial operational cost savings associated with this activity.

In addition to the provider-facing system, a Back Office application was implemented for Banmédica staff. This internal application enables employees to review, manage, and process payment requests submitted by providers through the platform.

Furthermore, through integration with IMED—a service that connects healthcare institutions, physicians, and patients to enable the issuance and processing of medical documents—the system supports voucher payment processing for large providers, such as the country’s major clinics and hospitals.