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Our web portal provides complete visibility of the entire claim management process while streamlining claim processes, allowing submission of cleaner electronic medical claims and receiving payment faster. 

Instead of shuffling paper and hoping claims arrive by mail,  submit your health insurance claims electronically.  It's faster. It's accurate. It's even cost-effective.   The Web Portal system will help you slash time, cost and bureaucracy typically associated managing healthcare transactions. What's more, you'll be able to reduce or even eliminate expensive paper-based processes and free those resources for higher value activities.

The Web Portal is bundled with an EDI X12 translator, automation engine, a powerful EDI data display, and an editing and validation engine. A multi-client enabled and centralized enterprise grade system; it is web driven to allow quick and efficient data entry and validation.

The Web Portal allows both client staff and system administrators to process EDI / X12 transactions securely over the Internet. It uses the Internet to completely eliminate the need for costly value- added network (VNA) processing and new customers become HIPAA EDI-compliant in minutes. It's the ideal solution for medical practices, managed care, billing clearinghouses, hospitals or any healthcare enterprise that needs to support insurance claim processing without having to implement an extensive, costly EDI transaction processing facility. 

The Web Portal is designed for institutions that need to collect claims from a large number of providers who are interested in greatly reducing or eliminating cost of traditional manual data entry, faxing, and mailing. It enables small and large providers to become EDI /X12 ready within minutes with minimal implementation effort. It works with the Internet using your web browser, and has a strong infrastructure using the most current cutting-edge technologies such as J2EE,  XML, and Service Oriented Architecture (SOA). 


Advantage

• Convenient, secure all-payer solution
• Faster reimbursement due to clean electronic medical claims submission
• Significant reduction in manual, error prone and paper-based processes
• Real-time claim error identification
• Online editing capabilities
• Printable reports by payer, provider or status
• Easy integration with existing practice management systems
• No special hardware or software requirements

Specifications

Data formats
Handles a variety of input formats such as 1500 print image, CMS 1500, 837, UB-04, NSF/UB92 as well as a number of legacy formats.  Supports translation of all the X12N EDI formats.

Security
HIPAA compliant - Allows secure connectivity using encryption and certificates as well as advance user authentication.    Access rights can be setup at multi-level for example sample users, operators and administrators.

Interfacing
Web based - no special hardware or software requirements.  The application server can interface to some legacy systems as well.  

Scalability
Handles high volumes of transactions - millions of claims a month.   Supports concurrency through parallel processing.

Audit Trail
Tracks all user actions throughout the claim processing cycle.

Administration
Administration console allows practice registration and user access control as well as work flow monitoring.

Modules

The Web Portal seamlessly connects healthcare providers and payers with an integrated suite of Web-based claim processing solutions that focus on each step of the revenue cycle:

Claim validation
Claim status
Eligibility check
Electronic remittance
Codes validation
Authorization
Enrollment