Product Features
Workflow Management
Member Management
Enrollment
Groups
Sub Groups
Confidentiality
ID Cards
EOBS
Benefit Management
Building Block Approach
Build and Reuse
User Defined Accumulator Hierarchy
Flexible Claims Rules
Cascading Benefits
Provider Management
Providers - Networks
Fee schedules – Cap schedules
Contracts – Business Segment
Provider Balance Payment
Credentialing
Fee Schedules
Capitation
Provider Balances
Hospital Management
Check Runs
EOPs
Medical Management
Case
Referral and Authorization
Assessments, Problems, Intervention, Care Plans
Claims Management
Customizable Processing Rules
Medical, Hospital, Dental, Pharmacy
COB, DOFR, Repricing
Claims Cascading
Adjustments, Voids, History
Mass Adjustment
Global Fee Schedules
Cascading Fee Schedules
On Demand or Batch
Attachments, Notes, Reminders
Document Attachments
Customer Service
Queues, Departments, Individuals
Subject, Contacts, History
Calendars, Notes and Attachments
User Tools
Customizable Rules
Customizable Screens
Dashboards
Reports
Analytics
Grids With Sort And Filter Functionality
Integrated With Word
Documents Attachments Across the System
Notes and Reminders Across the System
Production
Security
File Import and Exports
Preprocessing of Check Runs
Check Runs
Auto Assign PCPs
EDI - 5010
Letters and Reports
Job Scheduling and Status
Customizable Auto Adjudication Rules
Premium Billing
Invoices
Posting
Adjustments
Voids
For a free demonstration,
Schedule a consultation today.