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Average Ratings 0 Ratings

Total
ease
features
design
support

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Write a Review

Description

Claims adjudication services cover a range of areas including medical, dental, vision, and prescription claims, as well as short and long-term disability cases. These services can be accessed either on-site with a license or through a hosted application model (ASP). Utilizing Microsoft technology, the system is powered by an SQLServer database paired with a Windows front end. Our customer service is highly regarded, staffed by healthcare claims professionals who boast a minimum of 12 years of industry experience. All support inquiries are recorded, and their statuses can be monitored online. The system features a plan copy and modification tool that facilitates rapid plan implementation. Auto-adjudication is achieved through benefit codes that are constructed using business rules derived from over 25 variables connected to both the claims and the claimants, which are then processed by the adjudication engine. Claims can be submitted in various formats, including scanned images, EDI, or paper submissions. The system is compliant with HIPAA EDI 5010 transaction sets, ensuring secure and efficient processing. Additionally, re-pricing fees and UCR schedules can be pre-loaded into the system prior to their effective dates, while the date-driven logic ensures that re-pricing occurs based on the service date, optimizing the claims processing workflow. The comprehensive nature of this system allows for a more streamlined and efficient claims management experience.

Description

Tailored solutions for your unique requirements are now within reach. Sustain your ISO 9001:2015 certification effortlessly with inblueQMS, while providing swift solutions to clients using inblueRequest. Capture customer needs and monitor your response times effectively, all while classifying various registers. Experience the convenience of managing everything online, backed by over three decades of expertise in information technology development. The advantages of our software include enhanced centralization for planning, recording, and tracking processes and procedures. You will receive timely reminders for deadlines and notifications whenever a task is assigned to you, delivered via email or through dashboards. The platform is adaptable, allowing you to adjust fields to suit your company's specific realities and to set permissions and deadlines. Enjoy an intuitive user interface designed to simplify your tasks, complete with guided functions. Additionally, you can document comments and versions for thorough tracking, as the system maintains a detailed history of changes. Furthermore, the software provides insightful charts and result reports to help you gauge performance effectively.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

$8 per user, per month
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

Complete Health Systems

Website

completehealthsys.com/claims/

Vendor Details

Company Name

inblueQMS

Founded

2010

Country

Chile

Website

inbluesolutions.com/request/

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

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