Groupe Mutuel chooses Ilog to automate claims management

Source: Ilog

Ilog (NASDAQ: ILOG; Euronext: ILOG , ISIN: FR0004042364) today announced that Groupe Mutuel, a Swiss group of 14 private health insurance companies, chose Ilog JRules, a key offering in Ilog's Business Rule Management System (BRMS) product line, to automate its claims management processes.

ILOG JRules will be used as a core component of Groupe Mutuel's new service-oriented architecture (SOA).

Groupe Mutuel comprises 14 insurance companies and provides services for all insurance sectors (health, accident, life, death and disability insurance) to over 860,000 consumers and 10,500 businesses. Groupe Mutuel began an SOA initiative to overhaul its IT systems and unify the systems to enable better quality of service and improved competitiveness. An essential part of this SOA initiative is ILOG JRules, which will be used initially to automate its claims management processes, by checking health care invoices to determine eligibility for reimbursement.

"Within the context of overhauling our IT system, we were looking for a flexible and efficient tool to improve our health care invoices verification process and to be more reactive to business change requests", said P-M Revaz, CEO and founder of Groupe Mutuel.

Currently, about six million health care invoices are processed each year by Groupe Mutuel staff. With numerous types of invoices, payments, internal policies and special agreements negotiated with suppliers, invoice verification is the most labor-intensive task in Groupe Mutuel. ILOG JRules will help to automate the majority of this task, leading to fewer errors. In addition, Group Mutuel's business specialists can define, deploy or disable rules very quickly. ILOG JRules was fully integrated in Groupe Mutuel's new application and will ultimately replace all existing black-box decision logic used in their previous IT system.

A BRMS can be a significant part of a SOA strategy because it enables businesses to create decision services (rule-based services) that are truly reusable. Based on the premise that better transparency enables greater reuse (you can't reuse what you don't know), Groupe Mutuel uses JRules to provide access to the rules in decision services to all the participants of its lifecycle: developers, integration developers, service owners and policy owners, allowing them to collaborate, create, deploy, monitor and maintain transparent decision services.

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