iCare NSW is seeking a provider to speed up its digital invoicing and payments for a number of workers’ compensation services.
It’s kicked off the process with a preliminary request for information (RFI) for an “as-a-service” system to process more than 3 million invoices a year.
Solutions will need to support multiple claim types, “including Medicare, private health funds, and personal injury claims”, the RFI document states.
The system would handle digital payment processing for iCare’s nominal workers’ compensation services, the Insurance For NSW treasury managed fund workers’ compensation scheme, as well as the Lifetime Care, Workers Care, and Compulsory Third Party insurance care payments.
As well as making payments quicker and more efficient, iCare wants a system that provides “useful insights through data analytics”.
The system would need integration with POS terminals at healthcare providers, and vendors operating a POS-based solution “must be able to process claims without the need for a claimant to have a physical or digital card”.
Suppliers would need experience interfacing with Medicare and with state-based insurance schemes, and have at least a roadmap to practice management system integration.
Connections from the service provider to iCare need secure APIs for activities like invoicing, claims submission, claims validation and other data exchanges.
The RFI documents also note that most iCare services are currently hosted in AWS, and as far as possible the insurer wants an out-of-the-box solution “adapted to meet our needs through configuration, not customisation”.
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