1
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Step
Flowchart - MIP process
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Responsible Party
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Template/Guideline
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Explanatory Notes
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2
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Step
Enrollment of staff:
MIP Application/ Request for Change Form completed and submitted together with supporting documents in respect of staff member’s participation, including his/her eligible family members, where relevant
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Responsible Party
Staff member
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Template/Guideline
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Explanatory Notes
Education of staff about MIP and distribution of materials by the person most familiar with the scheme is absolutely necessary
If an office administers personnel on behalf of another agency for MIP purposes, the same rules procedures for UNDP staff must be followed
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3
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Step
Enrollment of staff:
Staff member and eligible dependents (where relevant) are enrolled in MIP in Quantum.
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Responsible Party
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Template/Guideline
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Explanatory Notes
In addition to ensuring the correct payroll calculation of these elements, the data entry process is also critical for reporting purposes and for the timely and accurate payments of MIP reimbursement claims
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4
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Step
Managing eligibility data in Global Payroll:
Data on enrollment form is verified and validated and any change in coverage is processed into Quantum promptly
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Responsible Party
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Template/Guideline
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Explanatory Notes
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5
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Step
Eligibility Data:
Reviews and validates eligibility data in the system and transmits file to claims administrative company
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Responsible Party
MIP HR Technical Support
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Template/Guideline
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Explanatory Notes
A technical interface uploads enrollment and eligibility data from Quantum and the claims administration company (TPA)
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6
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Step
ID Cards:
Uploads eligibility data; issues ID cards; and communicates exceptions, if any, to HR Technical support
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Responsible Party
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Template/Guideline
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Explanatory Notes
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7
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Step
Claims:
MIP claims are submitted through the online Claiming tool in a sealed envelope containing the MIP Refund Claim form and supporting documents directly to the company that administers MIP, following the instructions on the claim form
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Responsible Party
Staff member
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Template/Guideline
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Explanatory Notes
Effective January 2004, UNDP outsourced the administration of MIP claims to an independent administration brokerage company. The TPA company is responsible for administering MIP claims and for ensuring compliance by subscribers with the MIP rules and avoiding unreasonable or abusive use of the plan.
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8
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Step
Reimbursement of claims:
Claims are verified and processed as follows: - If the claim fully meets requirements, a payment instruction is
processed through interface between the TPA and UNDP and a Statement of Benefits is sent to the staff member - If the claim does not meet requirements, a notification and/or request for further information/documentation is sent to the staff member
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Responsible Party
Claims Administration Company
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Template/Guideline
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Explanatory Notes
Payment of claims is made through an interface between the claims administration company and Quantum. Payment that goes through this interface will not indicate the nature of the medical services provided.
Payment is made to the insured person, but, if the subscriber is no longer alive, payment will be made to his/her beneficiary as per P-2 Form Designation of Beneficiaries. Patient confidentiality will be protected as any MIP.
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9
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Step
Payments:
The payment instruction file received from the MIP Administration Company (TPA) is uploaded into system and an instruction is sent to UNDP to effect payment
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Responsible Party
MIP HR Technical Support
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Template/Guideline
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Explanatory Notes
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10
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Step
Payments:
Vouchers are uploaded, payments are processed and staff member is notified
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Responsible Party
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Template/Guideline
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Explanatory Notes
In order to effect prompt and timely payment, staff member must be properly set up as a vendor in Quantum
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