Extract
[...] Thus, in the face of this imperative, the CPAM has developed its organization to put in place a strategic continuity of activity with the sole ambition of maintaining its active and performing services. This condition has been particularly highlighted in the face of the Covid 19 crisis. Thus, within its organization, the CPAM has reorganized itself to put everything in place to ensure the continuation of its missions and main activities such as the reimbursement of care, but also the payment of daily allowances in the event of illness, for example, or the payment of pensions. [...]
[...] In fact, let us recall that the CPAM, as a public service, must be able to maintain a high level of demand for the treatment of insured requests and this all the more so in a crisis context requiring continuity of activity. The first digital support enabling the CPAM to provide its services remotely is based on the creation of an account by the insured: the ameli account. This tool has 36 million subscribers, who can then transmit their requests to the CPAM directly, but also track their reimbursements, download necessary documents such as a certificate of rights or daily allowance statements4. This account also facilitates exchanges between the insured and CPAM agents through secure email communications. [...]
[...] Social security then allows a coverage of health expenses but also to assist French citizens in case of illness, unemployment, work accident and retirement by paying income supplements. The social security system is divided into several branches according to the categories of intervention, including the CPAM which is then in charge of the branch illness intended to take charge of the health expenses of the beneficiaries. Thus, the main missions of the CPAM are defined by: "the affiliation of social insurance beneficiaries and the management of their health insurance rights; the treatment of medical care forms and health insurance benefits, the treatment of disability pension claims and their payment; the instruction of work accident or illness declarations, the application of an annual action plan on risk management, in relation with healthcare professionals; or the development of a prevention and health promotion policy (cancer screening, deficiencies, etc.)1. [...]
[...] Thus, in the context of the COVID 19 crisis example, the various CPAMs had to respond to this need by developing more phone lines to be able to respond directly to their insured. As a result, in addition to digital exchanges, insured persons can contact CPAM agents via the 3646 number, either directly or through a reminder from a counselor. The telephone call is essential to respond to all the demands of the insured and especially for those who are remote or who are not equipped with computers. [...]
[...] Thus, the CPAM plays a central role in managing Health Insurance in France. The organization of the CPAM Within the framework of the territorial organization of Health Insurance, several CPAMs have been created and distributed by department. Thus, currently each French department has one or more CPAMs to share the care of insured persons according to their places of residence. This proximity organization aims to best meet the expectations of insured persons. The different CPAMs also have the mission of working in coordination with all the healthcare professionals solicited by the insured persons, the various healthcare establishments or other organizations that are part of the Social Security, and this with the objective of efficiency and speed for an optimization of the care of insured persons. [...]
