Track insurer claims from beneficiary records through statements, payments and reconciliation.
Insurance / Mutuelle connects insurer and society records with beneficiaries, submitted claims, claim statements, insurer payments, receivables aging, reconciliation, official documents and audit history. Teams can see what was claimed, what was settled and what still needs review.
Move from insurer setup to claim processing and settlement review with supporting history.
Create, update and deactivate supported insurer-company and society records that define the parties used by insurance workflows.
Find beneficiary profiles, inspect related insurance transactions and generate supported beneficiary documents.
Review claim records, record supported adjustments and follow their status into statement processing.
Group eligible claims into a statement, preview its contents and use supported submission or cancellation actions subject to statement state.
Record insurer payment details and allocate amounts across payable claim records; review payment history and remaining amounts.
Review insurance reconciliation information and aging buckets for current, 31–60, 61–90 and older receivables.
Build supported official documents and review insurance audit entries and operation traces for accountability.
A claim can be followed through statement submission and payment allocation.
Record an eligible insured dispensing transaction
Review claims and assemble a statement
Submit the statement and track its status
Record insurer payment, allocate it and reconcile the balance
Review unclaimed claims and their current status before statement submission.
Inspect payment allocations and reconciliation records.
Use the aging view to review balances in supported time buckets.
The Web app supports insurer and society records, beneficiary and claim workflows, statements, insurer-payment allocation, reconciliation and aging. Insurance administration is restricted to managers or administrators with the required permissions.
Insurance-company administration requires manager/admin role and the relevant permission. Claim, statement and payment operations are subject to permission checks, business status and insurance settlement rules; audit history is available for review.
Insurance / Mutuelle is an Ultra capability. All access through the Web application also requires an active Ultra license.