GOSI's e-services have been introduced gradually and improved upon with the passing of time as well as branched out into more and more advanced frontiers. These services were necessary to face the following challenges: • Growth of establishments, contributors and beneficiaries • Expansion in new geographical areas to offer services for expanding businesses. • Service deterioration due to growth: lengthy lines, crowded parking lots, poor response time, process delays, cumbersome and inductive errors due to large volume.

The Jordanian Social Security Corporation (JSSC) has applied new techniques to enhance the governance, aiming to apply appropriate standards, mechanisms and best practices that ensure achieving the organizational goals in strategic level. Through implementing the policies, systems and processes to govern the work of JSSC and develop appropriate frameworks for the integration and involvement of all partners.

The Social Security Strategic Plan for the year 2017-2019 gave great attention to the distinguished services and that obivious in its Forth strategic objective « Enhance mental image of the corporation that contribute to extend the umbrella of social protection». and one of the most important value of SSC is the excellence service which is the basis of building all the policies, strategies and plans that have been developed to exceed the customer expectation.

The Social Security Corporation (SSC) in its efforts to reduce indebtedness and minimize evasion of payments of social security contribution has started to link electronically with stakeholders' databases to facilitate the warrants of attachment of movables and immovable of enterprises and individuals. Actually, the electronic exchange of data between SSC and the stakeholders stems from its strategic plan 2017-2019, that stated in its objectives "reduction of insurance evasion" and "strengthening the sustainability of the insurance system”.

In its efforts to enhance and facilitate the services and operations, the Social Security Corporation (SSC) has introduced a new electronic communication tool. This tool available in Arabic and English and provides various services to individuals and entreprises such as detailed information, personal profile, primary data for voluntary contributors, pensioners details, payments, transactions, and SSC numbers

Social Security Sustainability Reporting The Social Security Corporation (SSC) in Jordan published its first sustainability report in the year 2016 being the first organization between different independent, semi-government, and government organization to issue such report.

The National Health Insurance (JKN) Program is one of national strategic programs mandated by Indonesian Law managed by BPJS Kesehatan aimed to provide health insurance for all Indonesian citizens. The number of JKN participants as of May 1, 2018, has reached 196.62 million. The primary issue faced by this program is the high number of visiting participants to branch offices for administrative matters. Dissatisfaction towards long waiting times caused participation satisfaction index to decline since 2014 to 2016.

After a year of Indonesia’s national health security program (Jaminan Kesehatan Nasional or abbreviated as JKN), in 2015 BPJS Kesehatan instituted Pay for Performance (P4P) scheme in the capitation system for primary care providers. P4P in Indonesia is named Kapitasi Berbasis Komitmen Pelayanan (KBK) or Commitment-Based capitation, as means to designate commitment of primary care providers to deliver primary care services comprehensively. Unfortunately, resistance from primary care providers hindered its full execution.

Fraud incidence in healthcare is not easy to find. As a country that only started Social Health insurance (JKN program) since 2014, there are not many parties that provide fraud detection tools for INA CBG case-mix system. In addition, the law that establishes an investigation for potentially fraudulent incidents is still being drafted. On the other hand, there is a significant increase in the JKN’s participants & in the number of claims. By the end of 2017, the number of claims submissions were 80,641,271 cases.

Health Facilities Information System (HFIS) is a platform developed by BPJS Health of Indonesia to improve contracting accountability and referral system efficiency. Before HFIS, contracting mechanism was done and monitored manually which did not only time consuming but also sparked dissatisfaction from providers. Referral from a health facility to another was also not based on sufficient information about the availability of medical specialist or facilities of the referral hospitals.

Increasing number of Indonesia Health Insurance Program participants has greatly impacted on the increasing utilization of service and the number of claim reimbursement of BPJS Health. This change required a large number of additional resources and staff for claim administration processing. BPJS Health then launched an initiative to simplify claim processing and management so that less resources are needed. The initiative was named VEDIKA which is short for Digital Claim Verification, a digital application for the claim verification process for secondary health facility reimbursement.

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Test VR 2018-05-25