Benefits have always been one of the tools to attract and retain employees. These benefits tend to proliferate in a unionized environment and often come with complex terms and conditions. These benefits entitle employee to make claims either as benefit or expense incurred. As a result, HR not only deals with large number of claims but processing each claim can be a complex activity of ensuring compliance.
KaiZenHR Enterprise Claim Management allows you to define all the claims and enforces the business rules with regards to eligibility, quantum and ceilings. This will help ensure a consistent rule being applied to all claims and speedy processing to ensure payments are made on time.
Some key features of the module includes:
- Ability to user define all type of Benefits / Claims eg. Medical Expenses, Dental, Mileage Reimbursement, Club Membership etc.
- Setting of Eligibility Conditions (eg. Years of Service / Grading) and Limit Type (per month/year) for each Type of Benefit
- Provides analysis on total Claims made per Month, Quarter, Yearly by Employee / Department etc.
- Restricting some type of Claims and Benefits to certain group of Staff and the maximum amount they are entitled by Claim Grouping.
- Tracking of claims processed and ensuring that it does not exceed the limit.
- Ability to do manual Claim Balance Adjustment at any point of time eg. Additional approval by management
- Ability to do Benefit-In-Kind Tax Reporting in the annual EA form
- Maintaining a list of Panel Clinics to administer Medical Claims
- Analysis on Medical Claims across Years (eg. Last Year with This Year)
- Analysis on Medical Expenses by each individual Staff and their dependents.
- Provide analysis of Panel Clinics and number of patients attended to by Department and the medical fees charged.
- Allows flexibility of Claims to be updated to Payroll for Payment together with salary
- Recovery of overutilized Claims via Payroll deduction
- Claim application online with configurable approval routes.
- Viewing of claim utilization, limit and balance online via ESS.