Serbian Health Insurance Fund – SHIF (annual budget – US$ 2.6 billion) is a national institution for management of compulsory health insurance In Serbia. SHIF has 2,400 employees, 180 branch offices and manages financing health service for 7.2 million citizens. Soneco participated in several components of SHIF information system:
Database of insured and related records – The records on insured persons and related claims within the public healthcare system. The implementation included installation and configuration of more than 750 workstations and 170 servers, 25,000 hours of training, over 800 field activities, as well as data conversions at more than 70 sites, spanning over 2.5 million persons and 50 million records. Nowadays, records on all claims and services for 7.2 million citizens are in this database. The system is fully integrated with key external stakeholders: Tax Administration (health insurance contributions), Business Registers Agency (registered legal persons) and Treasury Administration (payments of contributions for health insurance on a daily basis), as well as with Pension Insurance Fund.
Electronic invoicing of medicines and medical aids prescribed and dispensed under mandatory health insurance coverage –The link between the SHIF and more than 1500 pharmacies, pharmacy chains and orthopedic companies. SHIF branch offices receive and process over 1000 electronic invoices with more than 5.5 million items each month, with 30 details about the insured person, dispensed medicine or aid, healthcare institution and issuing physician. The centralized database now has more than 300 million records.
Primary healthcare E-Invoice – This system collects and processes more than 15 million records each month, for calculation of coefficients used in the capitation formula.
Inpatient care electronic data exchange – The project is introducing the payment model based on diagnosis-related groups (Australian DRG). The project tasks included: management, development, and harmonization of the system for electronic invoicing and reporting on services rendered at the secondary and tertiary level of healthcare services (more than 8 million services each month). The project also included management of software development for grouping of services under diagnosis-related groups.