Assura commissioned ELCA to provide a system capable of dealing with TARMED invoices

 

Since its introduction on 1^st January 2004, the TARMED medical tariff has been used for invoicing out-patient services in medical practices as well as hospitals. Considered to be complex, the use of electronic data processing is crucial for the efficient deployment of TARMED, which comprises almost 4,600 positions and more than 10,000 rules of application.

 

In this context, ELCA opted for a solution based on the Sumex II framework of the Suva. This system replaces the manual checking of paper invoices with a computerised process. The ELCA projects team also set up a system to replace paper invoicing, based on the product FreeMind for Invoice (FMFI) from Itesoft which enables Assura to scan paper invoices and extract the data from these to send to Sumex II.

 

In 2009, as part of its system maintenance, ELCA engineers optimised the Sumex II system to take account of the significant growth experienced by Assura over these last few months, and they migrated the electronic FMFI system to a more recent version.

 

At peak periods this combination handles more than 10,000 invoices per day. In 2009, Assura received around 80% of its TARMED invoices in paper format (as against 20% in electronic format) and almost 45% of all invoices dealt with by the ELCA solution were processed without manual intervention, which has helped to ensure a reduction in costs whilst increasing competitiveness at the same time.