Added SMS Template Options
Create standardized SMS templates for credentialing or eligibility inquiries to streamline messaging requests.
Automated Medicaid Adjustments
Ensure precise billing with our automated system. It adjusts claims and copays for covered services—just indicate if it's Medicaid, and let the system do the math for you.
Automated Check Deletion
Simplify your check management and automatically delete related checks whenever you cancel a check run.
Chronic Care Admission Tracker
Easily monitor counts for unplanned admissions for patients with multiple chronic conditions that your Accountable Care Organization (ACO) handles.
Quick Access to Claim Files
Easily view relevant documents required for each processed claim. These are accessible on the tabulated list of claims logged in the system.
Review Member Deductions
Stay on top of revenue cycles by viewing a member's Net Available Monthly Income (NAMI) deductions for a specific NAMI deduction cycle.
General Updates
Review Member Deductions
Stay on top of revenue cycles by viewing a member's Net Available Monthly Income (NAMI) deductions for a specific NAMI deduction cycle.
Dashboard
Post-Care Tracking Insights
Say goodbye to manual searches. Conveniently access patients' approval letters straight from the authorization you are reviewing.
Chronic Care Admission Tracker
Easily monitor counts for unplanned admissions for patients with multiple chronic conditions that your Accountable Care Organization (ACO) handles.
Codes & Types
View Supervising Provider Information
Access all the relevant information on a specific supervising provider when adding a new entry for Provider Type.
Claims
Quick Access to Claim Files
Easily verify if diagnosis codes reflected in a patient’s claim are covered by the California Children’s Services (CCS) program to ensure accurate reimbursements.
Authorization/Referral
Added Interqual Integration
Create an Interqual medical review on applicable authorizations to ensure it passes the appropriate medical criteria.
Credentialing
Provider Status Protection
Keep operations running smoothly! Our system safeguards provider activity by preventing inactivation when linked to open claims or authorizations, ensuring seamless workflows.
Practical IAR Status Management
Make tracking applications easier by conveniently creating and assigning initial application request (IAR) status codes with an intuitive interface.
New Data Deletion Rules
Avoid accidentally erasing vital provider information with the newly added system prompts that require user confirmation before deleting.
Communication
Added SMS Template Options
Create standardized SMS templates for credentialing or eligibility inquiries to streamline messaging requests.
Eligibility
Seamless PCP Transition
Transfer members smoothly to a new primary care physician (PCP) and add notes about their previous PCP for an effortless handover.
Benefit Plan
Automated Medicaid Adjustments
Ensure precise billing with our automated system. It adjusts claims and copays for covered services—just indicate if it's Medicaid, and let the system do the math for you.
Maintenance
Automated Check Deletion
Simplify your check management and automatically delete related checks whenever you cancel a check run.
Contracting
Maximize Contract Listing Capacity
Free up listing space by deleting unused contract templates not connected to any assignments, making room for more relevant templates.
Connected Healthcare
HITRUST Risk-Based 2-Year Certification Achiever
The Health Information Trust (HITRUST) is a standards organization dedicated to security, privacy, and risk management. They developed the HITRUST Common Security Framework (CSF), which assists organizations in maintaining a comprehensive and secure approach to HIPAA compliance and managing risks. HITRUST is widely recognized as the benchmark in data security and privacy.
Certified Member of HCAA
The Health Care Administrators Association is the nation's largest nonprofit trade association for third-party administrators, stop loss insurance carriers, managing general underwriters, audit firms, medical managers, technology organizations, pharmacy benefit managers, brokers/agents, human resource managers, and health care consultants. HCAA has spearheaded the change of self-funding for more than 35 years.
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3233 N. Arlington Heights Rd.,
Suite 307, Arlington Heights, IL 60004
Phone:
847-222-1006
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LINKS
GET IN TOUCH
3233 N. Arlington Heights Rd.,
Suite 307, Arlington Heights, IL 60004
Phone :
847-222-1006
Fax :
847-222-1066
STAY INFORMED
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