Precision Unleashed: Unified PACE Lifecycles and Intelligent Claims Performance
QuickCap 7.25.4.0: Advancing Administrative Precision through Intelligent Automation
Instant MMR Data Integration
Close data gaps by uploading MMR files directly into the system. A dedicated member search tab ensures total transparency for PACE and HP lines of business.
Automated EDI Finalization
Eliminate manual file handling with auto-generated final 277s for 837P/I/D. The system triggers delivery the moment failed claims are noted.
Advanced Claims & Pricing Engine
Prevent zero-pricing with intelligent non-rural defaults for DME. This update integrates vaccine pricing, Micro-Dyn APR, and multi-page OCR document support.
Precision Benefit Calculations
Safeguard financial integrity with automated MOOP accumulations for SNF hospital admissions, aligning perfectly with plan-specific benefit limits.
Consolidated PACE Lifecycle Management
Centralizes enrollment, disenrollment, and referral workflows into a single, seamless interface that spans every phase of the participant journey.
Claims
Accuracy
Smarter DME Pricing for Rural Claims
Automatically apply non-rural rates when rural data is missing. It prevents zero-pricing errors while ensuring Medicare-compliant MPPR reductions.
Refined MPPR 3 Reimbursement Logic
Adjust Endobase PFS rates before reduction sequences begin. This logic ensures consistent procedure pricing and compliant RVUFS handling.
DRG Pricing with Micro-Dyn APR
Utilize the new Micro-Dyne APR Pricer to align complex DRG claims with standard MPPR reductions for reliable reimbursement.
Medicare Vaccine Pricing Integration
Automatically incorporate Vaccine-Admin rates into standard Medicare workflows for accurate, rule-aligned pricing.
New Automation
Enhanced OCR for Batch Claims
Streamline intake by uploading multi-claim PDFs and multi-page documents directly. The new Scan Documents link boosts OCR accuracy and processing speed.
Benefits
Financial Accuracy
Automated MOOP Tracking
Enforce precise limits proactively accumulating SNF hospital responsibility toward MOOP caps, ensuring every claim remains perfectly aligned with plan-specific financial rules for accurate benefit calculations.
EDI Services
Workflow Automation
Automated 277 Files Generation
Ease file management by auto-generating the final 277 files for 837P/I/D upon claim resolution to ensure accurate tracking with minimal manual efforts.
Eligibility
Data Visibility
Integrated MMR Visibility
Bridge PACE and HP data gaps via direct MMR file ingestion. The dedicated search tab provides instant member insights, optimizing reporting and eliminating manual lookups.
Pace Enrollment/Disenrollment
PACE Lifecycle Unity
Unified PACE Participant Management
Simplify the participant journey by managing PACE enrollment, disenrollment, and referrals through a single, cohesive interface for superior
operational control.
