Introduction

This module equips hospital systems with a complete solution for processing patient insurance claims. It manages everything from registering insurance companies and third-party administrators (TPAs), defining insurance packages, filing claims, handling documentation, and maintaining approval checklists—all integrated seamlessly into existing hospital workflows.

Key Features

• Register and manage insurance companies and TPAs for centralized insurance administration

• Define customizable insurance packages to match varying patient needs and coverage plans

• Handle insurance claim submission with built-in tracking and management tools

• Maintain detailed documentation and checklists for each claim to ensure compliance and completeness

• Integrate insurance operations directly into patient appointment and billing processes

Benefits

• Streamlines insurance claim processes for faster and more accurate reimbursements

• Reduces administrative workload with structured workflows and checklist management

• Improves compliance and audit readiness through organized document tracking

• Supports better patient care by simplifying insurance interactions during hospital stays

• Enhances transparency and accountability throughout insurance processing

Compatibility & Technical Details

• Technical Name: acs_hms_insurance

• Required Modules: Hospital Management System base, Appointment workflows, Patient billing and invoicing framework

• License: OPL-1 (Odoo Proprietary License)

• Installation Steps:

  1. Ensure foundational hospital management modules and patient billing systems are in place

  2. Install the acs_hms_insurance module to enable insurance workflows

  3. Register insurance providers, define packages, and configure claim and documentation settings for operational use