Resolution Insurance Tanzania
Resolution Insurance Tanzania: Integrated Healthcare Claims and HMIS Deployment
Connecting insurance claims operations with healthcare delivery across more than 40 facilities in Tanzania.
Client overview
Resolution Insurance Tanzania required an integrated digital platform capable of connecting insurance membership and claims-related processes with day-to-day healthcare operations.
The engagement extended beyond a single systems integration. Pillarsis deployed the eIntelliHealth Hospital Management Information System across more than 40 healthcare facilities in Tanzania, configured healthcare and insurance workflows, introduced biometric member authentication, and provided ongoing maintenance and operational support.
The solution was designed to help participating healthcare facilities verify covered members, capture accurate clinical and service information, support claims-related workflows, and maintain continuity across distributed healthcare operations.
Insurance and Healthcare
Resolution Insurance Tanzania
Context
Resolution Insurance Tanzania
Implementation
eIntelliHealth
Support
March 2020 through December 2022
40+ healthcare facilities
eIntelliHealth HMIS deployments across Tanzania
Integrated workflows
Healthcare operations connected to claims-related processes
Biometric verification
Insurance-member authentication at the point of service
Ongoing support
Maintenance and operational assistance following deployment
Engagement at a glance
A multi-facility digital health and insurance integration engagement
Challenge
Healthcare insurance operations depend on timely, accurate, and traceable information moving between patients, healthcare providers, and the insurer.
- Reliable verification of insurance members at the point of service
- Consistent healthcare data capture across participating facilities
- Integration between healthcare workflows and claims-related processes
- Reduction of manual and fragmented information exchange
- Clear management of workflow exceptions and incomplete records
- Secure handling of sensitive patient and insurance information
- Consistent system configuration across geographically distributed facilities
- Ongoing technical ownership after implementation
- Maintenance and support for healthcare facilities operating in live production environments
The solution also needed to work within the operational realities of healthcare facilities with different staffing levels, technical capabilities, and service-delivery processes.
Scope of work
Pillarsis delivered a combination of digital health platform deployment, insurance integration, workflow configuration, implementation support, and ongoing maintenance.
- Deployment of the eIntelliHealth HMIS to more than 40 healthcare facilities across Tanzania
- Integration of eIntelliHealth with Resolution Insurance Tanzania's claims-related workflows
- Configuration of patient registration, healthcare service, billing, and insurance-related processes
- Implementation of biometric authentication for insurance members
- Member identity verification at participating healthcare facilities
- Configuration of insurer-specific workflows and business rules
- Support for the capture and exchange of claims-related healthcare information
- Workflow validation and exception-handling processes
- Facility onboarding and implementation coordination
- User support and operational issue resolution
- Corrective and preventive system maintenance
- Technical documentation and knowledge transfer
- Ongoing production support during the approved project period
Delivery approach
Phased implementation from workflow assessment through production support
Pillarsis used a phased, facility-focused delivery approach that combined technical implementation with operational adoption.
Discovery and workflow assessment
The team reviewed existing insurance, clinical, administrative, and claims-related workflows. This included identifying data requirements, user roles, process dependencies, approval points, and common exceptions.
Solution configuration
eIntelliHealth was configured to support the operational needs of Resolution Insurance Tanzania and participating healthcare facilities. Configuration covered relevant registration, member verification, clinical, billing, insurance, and reporting workflows.
Integration implementation
Pillarsis implemented the required connections between healthcare operations and claims-related processes. The integration was structured to improve the consistency, traceability, and availability of information used during claims administration.
Biometric authentication
Biometric authentication was incorporated into the member-verification process. This allowed participating healthcare facilities to verify insurance members at the point of service and supported stronger identity assurance within the healthcare and claims workflow.
Multi-facility rollout
The eIntelliHealth HMIS was deployed to more than 40 healthcare facilities across Tanzania. Pillarsis coordinated configuration, onboarding, deployment support, issue resolution, and operational stabilization across the participating sites.
Validation and operational readiness
Configured workflows and integrations were validated against expected operational scenarios. The team reviewed standard transactions, exception cases, user permissions, and data exchange processes before and during rollout.
Maintenance and support
Following deployment, Pillarsis provided ongoing maintenance and operational support. This included troubleshooting, workflow adjustments, technical issue resolution, and continued support for the deployed healthcare facilities and integrated processes.
Technical solution
The solution used eIntelliHealth as the central healthcare information platform supporting clinical, administrative, billing, insurance, and claims-related workflows.
- A centralized HMIS platform for participating healthcare facilities
- Configurable healthcare and insurance workflows
- Biometric member-authentication capabilities
- Role-based access to clinical, administrative, and insurance functions
- Structured capture of patient, service, billing, and claims-related information
- Integration services connecting healthcare operations with insurer processes
- Workflow validation and exception-management capabilities
- Auditability of relevant user and operational activities
- Centralized maintenance and support
- A scalable implementation model suitable for multiple healthcare facilities
The design connected healthcare delivery with payer operations while maintaining clear separation of responsibilities, controlled access to sensitive information, and support for facility-level workflows.
Strengthening Member Verification Through Biometrics
A key component of the solution was biometric authentication for insurance members. The capability supported identity verification at participating healthcare facilities before or during service delivery.
By incorporating biometric verification into the healthcare workflow, the solution strengthened the connection between the person receiving care, the member record, and the associated insurance process. It also provided participating facilities with a more structured method for validating member identity at the point of service.
The biometric process was integrated into the broader eIntelliHealth workflow rather than operating as a disconnected identity system.
Security and data protection
Because the platform handled patient and insurance-related information, security and controlled access were important components of the implementation.
- Biometric identity verification for insurance members
- Role-based access controls
- Controlled access to patient and insurance information
- User authentication and authorization
- Traceable system activity
- Secure handling of claims-related data
- Consistent configuration of access permissions across participating facilities
- Operational support for security-related issues and user-access management
Key outcomes
- Deployed eIntelliHealth to more than 40 healthcare facilities across Tanzania
- Connected healthcare operations with Resolution Insurance Tanzania's claims-related workflows
- Introduced biometric authentication to support insurance-member verification at the point of service
- Established more consistent digital workflows across participating healthcare facilities
- Improved the availability and traceability of healthcare and claims-related information
- Supported standardized member-verification, service-capture, and insurance processes
- Reduced reliance on disconnected and manually coordinated workflows
- Provided continued maintenance and support after implementation
- Created a scalable digital-health foundation capable of supporting distributed healthcare-provider operations
The engagement provided Resolution Insurance Tanzania and its participating healthcare facilities with an integrated digital foundation for managing healthcare and insurance-related workflows. By combining a multi-facility HMIS deployment, claims integration, biometric member authentication, and ongoing operational support, Pillarsis helped connect payer requirements with healthcare delivery processes across more than 40 facilities.
Additional client-approved metrics, testimonials, service volumes, or performance results may be added after formal review and authorization.
Technologies and Solution Capabilities
Detailed infrastructure and technology-stack information is available subject to client approval and engagement confidentiality requirements.
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View serviceNext step
Modernize Healthcare and Insurance Operations
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