A comprehensive web-based and automated claims processing system for managed care organizations
Our managed care software solution is a "start to finish" healthcare delivery system that allows you to manage healthcare costs and quality of care including eligibility, referral and authorization processing, provider contracting, flexible pricing methodologies, benefit administration, auto claims adjudication, capitation (PCP and Specialty), EOB/EFT check processing, and EDI transfers and reporting.
- Managed Care Organizations (MCOs)
- Independent Physician (or Practice) Organizations (IPAs)
- Third Party Administrators (TPAs)
- Preferred Provider Organizations (PPOs)
- Self-Insured Groups
- Insurance companies and companies administering specialty products and services for mental health, home health, lab, physical therapy, etc.