Innovative solutions for the widespread use
of third-party payments for doctors

By introducing the idea of third-party payments becoming widespread by 2017, Marisol Touraine shook up a sector already experiencing strong tensions.

By proposing the management of the supplementary health insurance organisations via a "one-stop" CNAMTS (national health insurance scheme for employees), she highlights a management scenario often considered by supplementary insurers as atypical and highly questionable.




The widespread use of third-party payments poses a real technical problem: health professionals, especially doctors, do not want to be
bogged down with administrative tasks at the expense of their work;
they also want this service to guarantee them a certain and speedy settlement.

Yet the overall rejection rate currently observed for pharmacists
for the supplementary scheme, when managed by the Caisse Nationale d'Assurance Maladie (national health insurance scheme for employees),
is well above 4%.

SP Santé  
In this context, Cegedim Insurance Solutions offers various innovative solutions to address these issues:

  • Online convention
  • Complete integration of the service into the doctor's software, covering entitlement checking, calculation of the supplementary portion and also invoicing and payment
  • Automatic matching of invoices
This modern third-party payment solution for doctors is ergonomic and highly integrated by medical software developers.
It is a real seamless solution between doctors and insurers.

It is in line with the work of the inter-supplementary health insurance organisations, and is also part of its public service contract portal.

Key benefits of your third-party payment solution

An improvement
in health insurance provisions

  • Allowing the supplementary insurance organisation to offer this service in a context of modernity and
    in a new market segment
Third-party payments for doctors, an improvement in health insurance provisions  

Simple and secure functionality

  • Getting an up-to-date view of the member's situation in terms of their supplementary health insurance.

  • Securing third-party payment practices and drastically reducing undue payments

  • Establishing the express consent of the participant based on a module "trusted third party" certified by the CNIL to secure access to personal health data

  • Managing your reimbursements
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