Real Use Cases. Proven Impact.

Discover how leading insurers and managed care organizations use assistant by Medifit to automate processes, connect stakeholders, and deliver seamless healthcare experiences.

Insurers

MCOs

PROVEN IMPACT:

77% less processing time, 4x more claims per day.

A leading European health insurer partnered with Medifit to transform its claims handling operations and improve member experience. By embedding the assistant by Medifit platform into its existing claims ecosystem, the insurer unified data across policy, CRM, and claims systems, achieving automation from claim initiation to provider booking. Within just 14 months, the insurer completed full integration, connecting five major HIS systems and over 220 healthcare providers, while maintaining full compliance and data integrity.

77%
Time saved per claim (from 30 to 7 minutes)

4x
More claims processed

+65
NPS improvement (from 20 to 85)

Challenge

Traditional claims handling relied on manual communication, long processing times, and fragmented systems.

Key pain points included:

15+ representatives managing claims manually
Time-consuming pre-authorizations and document exchange
High dependency on healthcare providers (HSP)
Poor user experience and NPS below 20

Solution

assistant by Medifit connected the insurer’s policy, claims, and CRM systems directly with healthcare providers’ HIS.

The integration enabled:

Unified claim submission with automatic data validation
Online booking and direct service authorization
Automated document exchange between insurer, provider, and member
Rule engine for pre-authorization and auto-approval of 60%+ claims

Results:

4× more claims processed with the same workforce
Average time per claim reduced from 30 minutes to 7 minutes
Operational cost savings: 75% reduction in manual work
Customer satisfaction score: 4.7 / 5
NPS improved from 20 to 85

Each representative now handles up to 60 claims per day, compared to 15 before integration – achieving measurable productivity growth and significantly faster member service.

Client CX Impact

Members now experience a truly digital-first journey:

Fast, intuitive web and mobile interfaces for claims and bookings
Real-time claim and appointment status
Automated notifications (44 SMS and email triggers implemented)
Transparent communication between insurer, provider, and insured person

The insured member experience shifted from manual data entry and poor transparency (NPS <20) to seamless orchestration and real-time visibility (NPS 80+)

ZZ Zdravje: Digitalizing the Pravočasno Health Program

From manual administration to a fully digital membership experience. Powered by assistant by Medifit.

ZZ Zdravje is the leading and largest private medical center in the region, operating for over 30 years. With more than 30 outpatient clinics and a full team of in-house doctors and specialists under one roof, ZZ Zdravje provides patients with comprehensive preventive and diagnostic care - all in a single location.
Over a decade ago, the clinic launched the Pravočasno health program, a pioneering membership-based service that gives individuals and companies access to continuous, high-quality healthcare.

Challenge

The Pravočasno program had traditionally been managed in person, with members joining and paying at the clinic.
As the number of users grew, ZZ Zdravje needed a scalable solution to digitize the entire membership lifecycle: from onboarding and eligibility management to payments, usage tracking, and analytics, while maintaining compliance with internal processes and preserving the personalized care their patients value.

Solution

Using assistant by Medifit, the entire Pravočasno program was rebuilt as a connected digital ecosystem.

Members can now access the program through a dedicated web application, fully integrated with the assistant platform.
This setup allows complete control and connectivity between user experience and administration:

Digital onboarding that follows all ZZ Zdravje’s business rules and automatically validates user eligibility.
Centralized membership management: the admin team can add and manage both individual and corporate members in one place, create multiple program types, assign different services, and define custom usage rules for each package.
Full transparency: every member’s status, payment history, eligibility, and service usage are visible in real time.
Automated payment integration via Stripe, ensuring secure and effortless recurring billing after the initial pre-paid period.
Automated payment integration: ensuring secure and effortless recurring billing after the initial pre-paid period.
System interoperability: assistant can connect with ZZ Zdravje’s internal HIS system as well as external providers’ software, enabling seamless booking and document exchange regardless of the system in use.
Business analytics: real-time overview of all program activity with filtering by user type (individual or corporate), program version, and service category. The team can analyze performance, profitability, and utilization at any moment.

Every step, from registration and payments to service usage and program monitoring is now digital, synchronized, and managed through one unified platform.

Impact

The digital transformation provided ZZ Zdravje’s team with complete operational control and visibility over the Pravočasno program.
All user data, payments, and utilization reports are now managed through a single interface, reducing manual work and increasing accuracy and efficiency.

For users, the new web application connected directly to assistant by Medifit brought a simpler, faster, and more transparent healthcare experience, giving them digital access to appointments, documentation, and communication with the medical center.

This transformation modernized one of Slovenia’s longest-running health membership programs and made it ready for scalable growth.

Real Use Cases. Proven Impact.

Insurers

MCOs

PROVEN IMPACT:

77% less processing time, 4x more claims per day.

77%
Time saved per claim (from 30 to 7 minutes)

4x
More claims processed

+65
NPS improvement (from 20 to 85)

Challenge

Solution

Results:

Client CX Impact

ZZ Zdravje: Digitalizing the Pravočasno Health Program

From manual administration to a fully digital membership experience. Powered by assistant by Medifit.

Challenge

Solution

Impact

Let’s build your showcase.

From manual processing to full automation. assistant by Medifit delivers measurable results in weeks, not years.

Real Use Cases. Proven Impact.

Insurers

MCOs

PROVEN IMPACT:

77% less processing time, 4x more claims per day.

77%Time saved per claim (from 30 to 7 minutes)

4xMore claims processed

+65NPS improvement (from 20 to 85)

Challenge

Solution

Results:​

Client CX Impact

ZZ Zdravje: Digitalizing the Pravočasno Health Program

From manual administration to a fully digital membership experience. Powered by assistant by Medifit.

Challenge

Solution

Impact

Let’s build your showcase.

From manual processing to full automation. assistant by Medifit delivers measurable results in weeks, not years.

77%
Time saved per claim (from 30 to 7 minutes)

4x
More claims processed

+65
NPS improvement (from 20 to 85)

Results:

 Let’s build your showcase.