Positioning: An efficient processing mechanism combined with data early warning capabilities to create a trust-based service experience

Yihuibao has established a claims collaboration system and a risk control closed-loop platform covering three parties: hospitals, insurance companies, and patients, enabling efficient connection of post-operative claims processes, real-time tracking of risk events, and rapid disposal of problem feedback.

The service contents include:

Equipping dedicated claims managers to handle document submission, follow-up visits, and compensation feedback throughout the process, avoiding multiple coordination efforts by the hospital;
Connecting key data nodes such as the hospital's medical record department, medical insurance department, and operating rooms to realize a closed-loop mechanism of "active reminders for post-operative events + initiation of claims";
A 7x12-hour claims response channel and WeChat customer service portal, with a special rapid processing channel for major abnormal cases (response within 24 hours and feedback within 3 working days);
Regularly issuing Hospital Claims Event Analysis Briefs, Bulletins on High-Frequency Compensation Surgeries, and Risk Reminder Letters to assist hospitals in conducting department-level risk investigations;
Promptly issuing system warnings for situations such as consecutive abnormal surgeries, increased compensation rates for the same surgeon, and abnormal insurance participation rates in wards, promoting special rectification consultations;
Providing quarterly Service Improvement and Risk Suggestion Letters, covering claims dispute analysis, departmental insurance recommendations, and reviews of propaganda deviations, forming a data-driven + organizational co-governance service closed loop.