|
| |
The expEDIum Claims Portal is a web based Claims Processing solution that has a variety of features including web based account access and sophisticated high performing backend expEDIum Claims Portal Components that are powered by our proprietary expEDIum X12N Thin Engine and expEDIum Validation Engine.
This solution is an optimal way to allow Clearinghouses, Billing Services and Practices to connect to one or more Payers or Clearinghouses directly and make the claim life cycle management more efficient.
This solution supports a handful of legacy formats and can be extended to support additional formats on a need basis. The solution works with HCFA/UB92/UB04 forms and can be customized to work with any other standard/non-standard healthcare forms.
|
 |
| |
The main features of expEDIum Claims Portal solution are:
|
| Key Features |
- Multiple account support, each account can be a Clearinghouse, a Billing Service Bureau or a Practice.
- Legacy file format support.
- Batch uploads and processing.
- Patient Demographics Capture and lookup.
- Primary and Secondary billing.
- ICD-9, CPT, HCPCS code lookups and validation.
- Taxonomy code lookup.
- UPIN lookup from custom URLs.
- Exhaustive payer list and lookups.
- Standard healthcare form based L1, L2, L3 validation and scrubbing.
- Rule based routing of Electronic or Paper claims.
- Printing of HCFA/UB04 Paper claims.
- Multiple Trading Partner Profiles/Multiple Payers.
- Creation of Payer Ready Electronic EDI claims.
- Archival of batches and claims.
- Customizable data edits and business rules.
- Reports module to create customized reports in PDF, CSV or HTML formats.
- Message based communication with users from Portal Administrator.
- Production driven, High performance solution.
|
| Client side access |
- Web based secure provider/client access
- Account Password expiry.
- Provider side reports viewing and downloading
- Provider side upload of legacy format files
- Provider side claim scrubbing
|
| Automated Payer Connectivity |
- Extensible Payer Edits module.
- PGP and ZIP with password support.
- Direct Payer connectivity and multiple payer support.
- Dialup support.
- Standard Secure transportation mechanisms such as SFTP, FTP over VPN and HTTPS.
|
| Technology |
- Open database and standard Internet browser support.
- Needs an Application Server such as JBoss.
- Platform independent, J2EE based scalable solution.
|
Please request for a remote demo of our Claims Portal solution.
|
