Built for the Details: Sharper Adjudication and Compliance Logic
QuickCap 7.26.1.0: For The Operational Details Payers Actually Deal With Every Day
AI-Powered UB04 Claim Scanning
Upload UB04 scanned images and let our expanded AI-powered OCR handle the extraction. Claim data lands directly in the Scanned Claims module: ready for intelligent review and automated creation.
Bilateral Surgery Pricing
Price bilateral procedures correctly within the RVUFS Standard Medicare workflow. Precision pricing logic runs for every reporting method, keeping your adjudications accurate and consistent.
Built-in Recoupment Support
Recover previously paid amounts through a defined reversal process for void and reversal claims. One claim holds in Release to A/P status, giving teams a trackable recovery path without manual workarounds.
1-Day Mail Order SLA
A 1-day SLA option is now available at the transaction level for mail orders. The option is selectable at both the Letter Template Mapping and manual dispatch screens to accelerate urgent communications.
Dental Claim Benefit Rules
Configure benefit rules specific to dental claims and apply matching DOM logic during adjudication. Dental workflows now operate with the same rule-based depth as other claim types in the system.
Qualifying Provider Classification
Tag providers as QP or Non-QP on their profile, and the pricing logic does the rest. The system automatically applies the correct conversion factor during adjudication based on the classification.
IRS-Compatible 1099 CSV Export
Generate 1099 MISC and NEC files in CSV format for direct submission through the IRS IRIS portal. No extra formatting required: just compliant filing aligned with current IRS filing standards straight from the system.
Claims
Claims Adjudication
Bilateral Surgery Pricing in Standard Medicare
Apply accurate bilateral surgery reimbursement logic within the RVUFS workflow. The enhancement covers pricing across all reporting methods to ensure consistent, Medicare-compliant adjudication.
Qualifying Provider (QP) Flag for APM
Identify qualifying and non-qualifying providers directly on the provider profile. Separate conversion factors are applied during claims pricing for transparent, policy-aligned reimbursement calculations.
Structured Void Claim Recoupment
Manage financial recoveries through a controlled reversal workflow. One claim is held in Release to A/P status to enable accurate recovery, eliminating the need for manual external processes.
Dental-Specific Benefit Rules and DOM Application
Configure benefit rules exclusively for dental claims. The corresponding DOM application logic applies these rules during adjudication, bringing seamless rule-based processing to dental workflows
Scanned Claims
AI-Powered UB04 OCR Processing
Upload UB04 claim images and extract institutional claim data automatically. The system enables review and claim creation within the Scanned Claims module, replacing manual document handling with AI-powered efficiency.
Report
Claims
1099 CSV Export for IRS IRIS Submission
Generate IRS-compliant 1099 MISC and NEC files in CSV format for direct submission through the IRIS portal. This reduces manual formatting efforts and ensures compliance with current IRS filing standards.
Letter/SMS/Call Template
Template Mapping
Configurable Mail Order SLA
Select a 1-day SLA option at the transaction level for individual mail orders. Urgent orders are routed for faster processing to improve operational responsiveness without disrupting standard workflows.
