Seeking innovation and greater excellence in the provision of services, Silvestre Saúde, one of the oldest health plans in Brazil, entered into a partnership with MV and is already in the implementation phase of SOUL MV, a complete platform that organizes and controls administrative, financial and management processes of health plan carriers.

With a concern to meet the challenge of data integration, increase productivity and, above all, fully meet the requirements of the National Regulatory Agency for Private Health Insurance and Plans (ANS), which determines various legal obligations, including the availability of files that inform the monthly turnover of beneficiaries, expenditure on consultations and exams, and the registration and financial information of the carriers, approximately 60 employees of Silvestre Saúde are being trained by MV’s team.

Next semester, the health plan carrier will rely on the SOUL MV solutions, which in addition to simplifying the management of contracts and facilitate the processing and auditing of accounts, also ensures more quality to the information through the traceability of integrations with constant updates and the elimination of the excessive number of manual controls by the parameterization of rules within the solutions. With this parameterization, the users are not required, for example, to use spreadsheets or printed materials to check how to correctly perform certain procedures. 

Another important benefit ensured by SOUL MV is the TISS monitoring - Version 3, a recent requirement released by ANS to view more deeply the use of the carrier by the beneficiaries. According to Vilson de Oliveira, director of Silvestre Saúde, the management system used before was not in line with the management expectations of the company and was not providing the information required by the regulatory agency. “The decision to choose MV was based on the software`s ability to meet these needs and also add value to the business,” he said.

Since MV system also offers web services, the beneficiaries and client companies of Silvestre Saúde will have access to the self-service. Without paperwork or the need for personal attendance, directly on the carrier’s website the beneficiary will be able to update the information and check out waiting periods, request refund and medical forms, obtain the income tax statement, issue bank slips and duplicate copies of invoices, etc. The client companies will be able to have control of the beneficiaries, issue certificates of discharge and use of health plans, have access to billing data and many other services. 

For sellers of the carrier’s health plans, MV system also provides advantages. The possibility of online sales is one of them. Instead of filling out paperwork with several customer data and having to send to the carrier for the formalization of a contract, the seller can access the website, file the proposal and automatically make the client a beneficiary.

Associated with Rede Adventista Silvestre de Saúde, which includes the first private hospital of Rio de Janeiro and the first in the world to perform pancreas transplant, the carrier pioneered by launching, in 2009, the health plan for the elderly in Rio de Janeiro.

Salutar Saúde in the portfolio of MV

In just over a month, Salutar Saúde noticed that it needed to improve its processes and did not hesitate: it entered into an agreement with MV and started the implementation of SOUL MV. With approximately 30,000 lives and a strong presence in the city of Rio de Janeiro, the carrier, which has been in the market for more than 15 years offering health plans, is facing challenges due to the lack of automation.

“To carry out any procedure with our beneficiaries and clients we need to involve the call center. With the implementation of the MV system, we expect to modernize our processes, reducing this dependence and hence improve the performance of healthcare,” said the IT manager of Salutar Saúde, Márcio Loureiro. Through SOUL MV, the carrier will have access to a relationship management tool that provides information about the relationship with the beneficiaries, companies and service providers, in addition to services and ensuring the compliance with ANS requirement with regard to the Ombudsman. 

Since the implementation project of MV system is expected to be completed in the coming months, approximately 40 employees are already in training.