JRules for Policy Management
Comprehensive catalog of thousands of rules
Congratulations on securing a new enterprise group deal and signing the contract! Now it's time to onboard your insured clients and establish the unique rules requested by your enterprise customer to finalize the deal. JRules provides a comprehensive catalog of thousands of rules, allowing you to quickly align them with the contract items.
We understand that implementing new rules can be a challenge and often turns into lengthy IT projects, causing your pre-authorization and claims teams to manually manage operations. With JRules, you can implement new rules in just hours, not months, streamlining the process and saving valuable time.
Policy production is a critical aspect where even minor errors can result in significant budgetary losses. Selecting the right rules that comply with the contract is essential, especially when dealing with lengthy contracts containing numerous business rules. Our solution simplifies the selection process, making it accessible to employees at all levels.
Using our user-friendly, step-by-step process, you'll first choose which illnesses are covered, followed by waiting periods, limits, cover redirections, and pregnancy and maternity emergency admission rules.
Each policy is different, so is JRules!
We know you have hundreds of different enterprise customers and each one has different special clauses, changing your original policy templates.
We have screened over hundred thousand pages of insurance policies and created over 2500+ business rules to match your needs. The platform is fully customisable by your policy managers and product owners thanks to Decision Center.
Scope of Rules
- Covered and Uncovered Diseases Groups for inpatient, outpatient and treatment
- Network Management Rules
- Policy Management Rules
- Pricing/Service Procurement Rules
- Deductibles and Cover Limit Rules
- Covers Management
- Pharmacy and Vaccination Rules
- Waiting Period Management
- Emergency Admission Rules
- Maternity and Newborn Rules
Over 250 parameters are checked and controlled, including
- ICD-10 Codes, Health Service Codes
- Age, Gender
- Waiting Periods
- Doctor Specialty
- Cover Limits and Cover Redirection
- Surgery/Inpatient Rules
- UW Exemptions
- Patient History
Health Insurance Solutions
Our vertical expertise sets us apart
We are ranked among the best providers in EMEA region
Banking
Change your bank’s approach to develop more significant customer bonds and generate fresh business expansion prospects.
Insurance
Drive your insurance company forward with our tailored solution packages for a wide variety of next generation insurance products.
Public Services
Shift your service quality covering the demands and expectations of citizens with seamless online transactions.
Energy
Unleashing your data by our innovative solutions helps you increase the validity of the supply-demand balance planning by accurate estimation.
Retail
In this hostile and demanding environment, we help you shift to profitability by optimizing your stocks and managing competition.
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