Health Assurance System Case Study

Case

Starting off with the slogan "Health comes first", Acme Holding has stepped into the period of meeting and managing the health care expenditures of its employees and employees' relatives in contracted or non-contracted institutions. In this context, when Acme holding employees receive treatment in non-contracted institutions, they request health expenditures through the Workcube system and obtain the amount to be covered by the company as an additional allowance. In contracted institutions, they can get their treatments without paying any fee.

Transactions

Preliminary Transactions

1. Register Contracted Health Institutions as "Accounts"
2. Go to member detail screens of contracted institutions
3. Make the accounting account definitions of the Contracted Institutions
4. Make the necessary definitions for employees and their relatives from the Health Expenditure section on the "Payroll Flow Parameters" screen to reflect health expenditures on the payroll.
5. Make the necessary "Process" definitions for Health Expenditure Receipts, Health Documents, Health Expenditure Request and Health Expenditure Approval and define the authorized persons at the process stages
6. Health Expenditures and Contracted Institution Health Invoices Define "Transaction Categories" and select authorized persons in these transaction categories
7. Define Treatment Categories
8. Define treatment types
9. Define drug and medical supplies definitions
10. Define limb-organ definitions
11. Define "Health Coverage Types" for limit usage control and details
12. Define "Additional Allowance" for the employee and his/her relative, including your information on how your Health Expenditure will be reflected in the payroll as an additional allowance.
13. Define "Deduction", which includes your information on how your Health Expenditure will be reflected in the payroll as a deduction
14. If you want Additional Allowance to be Defined for Relatives of Employees in the Health Department, select Yes on the Payroll Flow Parameters XML screen.
15. From the Health Expenditure XML screen, set your preferences for Payroll Reflection, Limit Calculation Method, etc.

Main Transactions

1) Conversion of Employee Health Expenditure Request to Health Expenditure

1. Staff requests health expenditure
2. HR specialist checks and approves health expenditure request and updates the process to accounting and payment steps

2) Conversion of Contracted Institution Invoices to Health Expenditures

1. HR specialist checks the contracted institution invoices and records them as "Health Expenditure Receipt"
2. The HR specialist is directed to the health expenditure screen by clicking the "Check Spending" button in the detail of the relevant invoice in order to convert the health expenditure receipts into health expenditures.
3. Adding forwarded health expenditure page opens with the relevant fields in the invoice detail filled. The specialist completes the registration by filling in the required fields here.

Post-Transactions

1. Check accounting records of health expenditure
2. Check current records of health expenditure