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Claims and payments processing module
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An intuitive tool for eligibility checks and claims submission. Enables care providers to compose claims based solely on their preferred procedure classification system, while the payors receive CPT or any other codes of their preference.
Billing between care providers and payors is radically simplified or completely eliminated by setting up settlement periods for automatic processing.
Medical case functionality to support semi-automatic adjudication with expert adjustor involvements and complete case files' management including examinations, test results, conclusions, DRG assignments. Allocated limit control, limit extension procedures.
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Straight through processing for more than 90% of all claims
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Electronic claims submission
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Automatic policy validation and eligibility check
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Automatic split-second response including coverage amount calculation
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Immediately calculated co-payment with all rules automatically applied, deductibles checked and limits observed
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Case management functionality for complex cases requiring supporting medical documents
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Save time and money on claim processing with INMEDICAS
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