EClaimEasy
Streamlines your EClaims administration
E-claims solution for medical providers and insurance service providers.
Automates creation and submission of e-prior requests and e-claims to Regulator post office.
Monitor, downloads and notifies upload of authorizations and remittance advices.
Supports all eclaims transactions required by the Regulator.
Features
E-Prior Requests
Automatically identifies services that require authorization and create prior request from an encouter. Edit and finalize requests created by the system before submission to post office. Notifies you when authorization response is received on the post office.
E-Claims
Manually create eclaims from scratch or import and validate claims from excel or converts approved prior requests into e-claims holding corresponding authorization number eliminating the invalid authorization numbers error.
Price List
Upload and maintain one active cash price list. Create one active discounted price list per each claim amdministrator agreement. Solution picks up prices of entered services as per agreement price list of the current patient's claim administrator. Apply price increase to the cash price and create new cash price list and adjust agreements' discount percentage as per price increase negotiation with claim administrators
Advanced User Privilages Allocation System
Data is stored on provider's server and regulator post office. Provider's IT has full access to EClaimEasy database meanwhile end user has access to the database only through loggin into EClaimEasyas as per granted user priviages. User privilages are granted at three levels : 1- Fomrs 2- Buttons' Functions 3- Data Entities like payers
Platform Management Office
Create teams like processing, coding, submission and resubmission. Assign privilages to team members like limiting a user to specific payer. Distribute daily claims quota to users. Monitor daily work progress like per user daily backlogs, work mile stones TAT Track overall backlog development and take proper measurements
Patient Health Card
Keep track of plans information pertaining to patients visiting provider location.
Plans information is maintained under each claim administrator.
Create patient insurance card and assign one of the plans of the claim administrator who owns patient insurance card.
Standard Codes Updates
Daily automatic update of regulator codes and lists which ensures up-to-date halth authority standard codes in the system.
Application Updates
Automatic update of EClaimEasy every time new features are added or when business and validation rules are updated by the regulator.
Inquiries
Flexible criteria for searching data which provides powerful inquiry tool for prior requests and authorization, patient visits, submission claims, remittance advices and claims data. Entities search allows answering the questions like Prior requests waiting for submission Prior requests that were answered by payers Claims pending for remittance advices Claims payment status Claims Aging