Random sampling of insurance claims for Nepal's Health Insurance Board

During the COVID-19 pandemic, Nepal's Health Insurance Board needed to review a very large number of insurance claims every day without adding staff.

We developed an openIMIS solution for the random sampling of claims. It lets the Board process thousands of claims per day with fewer people, and it helps identify potential fraud.

After extensive testing, the functionality was integrated into the core openIMIS product, so other countries running social protection and health financing systems can adapt it too.

This post summarises the openIMIS community's own account of the work. Read the original at openimis.org.