Cegedim, CRM and DMS interconnection — intelligent fraud detection — automation of benefit, contribution and income protection calculations. A coherent view of your data to manage your mutual insurer with confidence.
Request a free diagnostic →Heterogeneous systems, manual processes and growing regulatory pressure that undermine your operational efficiency.
Cegedim, CRM, DMS, reference databases: your member, contract and benefit data live in siloed systems, generating inconsistencies and constant duplicate entries.
Without automated data cross-referencing, anomalies in healthcare reimbursements, suspicious cumulations and fake profiles slip through the cracks.
Tiered contributions, out-of-pocket calculations, income protection guarantees, portability: business rules are complex and calculation errors are costly in terms of claims and reputation.
Bank reconciliations, payments to healthcare providers, contribution accounting and technical provisions: too many manual steps slow down the accounting close.
Custom SaaS solutions and consultants embedded in your teams
Cegedim connector, CRM integration, centralized DMS and unified reference data to create a single source of truth for your members and contracts.
Configurable business rules engine, Machine Learning scoring and alert workflow to identify anomalies before they become costly.
Contribution engine by tier, 100% Sante benefit settlement, integrated income protection and automated accounting reconciliation.
Master Data Management, cross-system consistency checks, intelligent deduplication and real-time Data Quality dashboards.
Free audit of your processes within 48 hours
Request a diagnostic →We build the integration foundation that connects Cegedim, your CRM, your DMS and your reference databases to create a single source of truth for your members and contracts.
Our detection engine automatically cross-references reimbursement data, member profiles and care histories to identify anomalies before they become costly.
Real-time collection of reimbursement requests
Ceiling verification, duplicates, incompatible procedures
Behavioral analysis and pattern detection
Prioritized case with risk score and context
Approval, rejection or in-depth investigation — everything is traced
We make your entire accounting chain reliable: from contribution calculations to provisioning, including benefit settlements and income protection, for faster and error-free closings.
With data spread across 5, 10, sometimes 15 different systems, inconsistencies pile up. Our Data Quality approach restores order and maintains reliability over time.
Our expertise covers the entire technological ecosystem of mutual insurers and supplementary health organizations.
Noémie flows, third-party payments, reimbursements and healthcare provider management
Member relationship management, campaigns, complaints and omnichannel customer journey
Digitization, OCR, automatic filing and regulatory archiving
CCAM and NGAP tables, nomenclatures, guarantee grids and contribution scales
Accounting entries, technical provisions, reconciliations and Solvency II reporting
Claims dashboards, loss ratio, cancellation rate and sales management
Identity management, SSO, role-based access control and GDPR compliance
Member chatbot, automatic mail classification and settlement assistance
Before/after comparison on key performance indicators of a mutual insurer.
If you check 3 of these 6 signals, it is time to act.
We develop custom connectors via REST API and file processing (Noémie flows). Exchanges are bidirectional and real-time: reimbursements, rights updates and contract movements automatically propagate to your CRM, DMS and reference databases.
The process combines two levels. First, a configurable business rules engine detects anomalies: duplicates, cumulative reimbursements, incompatible procedures according to the CCAM. Then, a Machine Learning model scores each request. At-risk cases are escalated through a dedicated workflow.
We develop a rules engine that encodes your pricing grids, guarantee conditions and scales. For contributions: age brackets, schemes, ANI portability. For benefits: reimbursement bases, guarantee rates, caps and 100% Sante. Every calculation is traced and auditable.
Yes. The income protection module covers daily allowance calculation, disability (categories 1/2/3, annuity), temporary incapacity and death benefits. Mathematical provisions are calculated automatically and integrated into accounting entries.
A first pilot (Cegedim + CRM interconnection on a portfolio) is operational in 6 to 10 weeks. Full deployment — including anti-fraud, accounting automation and data quality — spans 4 to 8 months.
Free audit of your processes within 48 hours. Our experts analyze your needs and propose a tailored solution.
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