The expEDIum Claims Portal (eCP) is a standard based, secure Web-based Electronic Claims Processing and affordable Claims Adjudication Software that allows users to effectively manage complete claims life cycle and automate claims processing workflow seamlessly. This solution is ICD-10 codes ready and meets every standard based change in the industry without any additional cost to clients.

The expEDIum Claims Processing Software is an optimal Solution for Third Party Administrator (TPA), Administrative Service Organization (ASO), Independent Physician Associations (IPA) and other Healthcare Claims Processing Organizations to streamline the medical claims processing and manage the claims payments cost effectively.This solution allows provider side to access and directly submit claims electronically and perform online referrals/prior- authorization request.

This comprehensive solution makes users more efficient in managing practices, easy to handle the whole claims life cycle, managing denials & rejections, effectively control payments and rules. This Cloud based solution is available at affordable monthly based subscription. This solution can be integrated with other Practice Management Solution & Billing Software or other Clinical Applications.

Key Features

Effectively manages complete ASO/TPA workflow

  • Allows to send prior-authorization request directly by providers and see the responses
  • View and effectively manage integrated patients data from a single window
  • Manages authorizations requests from various provider from a single screen
  • Manages the complete claims life cycle and adjudications of claims
  • Integration with other PMS or Billing Applications

Claims processing is much efficient now

  • Simple claims creation screen and many fields are auto filled
  • In-built Claims validation & scrubbing
  • Claims Database & several filters
  • Direct claims submission by providers or practices
  • Multiple accounts supports and can be assigned privileges

Comprehensive Claims Life Cycle management

  • Claims Denials and Rejections managements
  • Claims History and tracking of the status
  • Capabilities to create ERAs and EOBs from the system
  • Integrated claims data from various account and analytics
  • Direct payer connectivity feature allows to connect with payers directly if necessary to submit claims and auto reconcile payments

Reports and Data Analytics

  • Several dashboards and customized view
  • Better data analytics module
  • Availability of information and intelligence
  • Several in-built Reports and on demand
  • Limited customization & provides flexibilities to partners