Insured Database Integration

Osigu requires certain information about insured members to perform various validations, protocols, and business rules during authorization.

Payers can use three methods to provide Osigu with the required information. The payer can choose any integration method, allowing Osigu to perform beneficiary searches, eligibility verification, and more.

1.1 Web Service

This is the most commonly used method, in which the payer provides Osigu with a service that enables beneficiaries to search for and retrieve information about their policy or plan.

The platform will use this service in real-time, meaning it is called when the beneficiary visits a healthcare provider, requests a prescription/authorization, or during a dispensation process.

See Beneficiary Information and Beneficiary Search.

1.2 Via Files

The payer regularly uploads CSV files containing the information required by Osigu.

Osigu will not query the payer further; instead, it will operate all processes using the most recent information provided through this method.

These CSV files must adhere to a predefined structure set by Osigu to be successfully uploaded.

Files can be transferred to Osigu's servers via NSF or SFTP, depending on what is most convenient for the payer. Once the files are transferred, Osigu automatically processes them.

See the File Uploads section.

1.3 Osigu Web Service

The payer may choose to use a high-availability service provided by Osigu, which accepts information about policies/plans, beneficiaries, and coverage.

With this method, the payer must identify the points in their process where a beneficiary is added or undergoes changes in coverage, conditions, or validity. When these events occur, the payer can call the Osigu web service to send the updated information. This ensures that Osigu’s data is as close to the information registered within the payer’s systems in near real-time.