Insurance & health funds

The problem a coverage body has

A reimbursement file passes through at least four parties: the member who submits it, the healthcare professional who bills, the manager who checks it, and the accounting system that pays. Each needs a different view of the same data, with different rights. Until those views exist, the work happens by e-mail, phone and paper — and traceability disappears.

What we build

• Member portal — entitlements and benefits, submitting a pre-authorisation request, real-time reimbursement tracking, claims history.
• Healthcare-partner workspace — online entitlement checks, electronic invoice submission, payment tracking.
• Manager back-office — file processing, reimbursement approval, benefit configuration, contract management, reporting.
• Member mobile app — digital membership card, reimbursement tracking, notifications.

Our reference: LAMAS

We delivered exactly this system: four interfaces on a MySQL and Oracle infrastructure — the dual database serving both transactional performance and compliance constraints. The result: the member journey fully digitised, processing times substantially reduced, and electronic invoice submission by healthcare partners.

The regulatory context

Restructuring in the mutual-fund sector is forcing several bodies to rebuild their information systems. Separately, the data involved — health, identity, financial details — is sensitive under Moroccan law 09-08: fine-grained roles, access traceability and retention periods are not optional. See CNDP compliance.

How we work on these projects

Rarely alone. On a coverage-body system we are glad to act as the platform specialist inside a team led by an established integrator — that is more honest, and safer for the client, than a small firm claiming to carry all of it. The initial scoping engagement is short and paid, and you keep the document.