ISSI Claims Administration
The ISSI Claims Administration System provides:
- User Friendly Data Entry Screens
- On-line Eligibility Determination based on date of service
entered
- Automatic Testing for Duplicate Claims Submission based on
multiple criteria
- Parameter Driven Software Design facilitates easy modifications
to the schedule of benefits
- A Search Feature which allows the user to easily access participants,
doctors, hospitals, procedure and diagnostic codes
- Updating of Participant Address at time of claims entry,
if needed
- New Dependents can be added at time of claims entry, if desired
(newborns, etc.)
- New Providers can be added at time of claims entry, if desired
- Support for Multiple Offices per Provider, as well as multiple
providers per office
- On-line Claims Inquiry for a specific claim or for the claims
history of an individual adjuster
- Claims Adjuster Profiles which govern the functions of an
individual adjuster
- Full Support for Coordination of Benefits
and/or Co-Payments
- Claim Check Printing: with or without EOBs
- Claim Check Registers
- Coverage Limitation Determination
- Comprehensive Security:
Passwords, thresholds and audit trails
- Complete Documentation of the entire system
- Supports Several Different UCR schedules
- Claims can be put on hold, and follow up letters/reports can be generated for those claims
- Assignment of Payments to a Participant, Provider, Beneficiary, or Third Party
- Ability to Integrate On-line Claims Edit technology from Medicode
- General and Internal Comments
- Complete Management Reporting including plan coverage analysis and claims experience based on procedures, providers individuals, families, plans, date ranges, categories ... and much, much more!!!
To return to our general overview of our Claims Administration System provides, please click here.
|
ISSI Benefit Administration System
|
