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| The expEDIum Claims Reconciliation solution (eCR) provides direct payer connectivity along with an automated and secured way of making the claim life cycle management more efficient and cost effective. This solution is HIPAA enabled and natively handles all data in HIPAA compatible formats. The eCR solution is ideal for Billing Service Bureaus, Clearinghouses and small to medium sized hospitals who would want to supplement their existing billing system to provide direct payer connectivity. |
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The main features of expEDIum Claims Reconciliation solution are:
- Process driven approach.
- Automated processing of 837(P, I, D), 835, 270/271, 276/277, 278/278R, 997 transactions.
- Support for HCFA print image, UB92/UB04, NSF or any other standard/legacy healthcare format.
- Additional legacy healthcare format/encryption/processes built on demand.
- Scheduling and Prioritization of expEDIum Profiles.
- Multiple Payer support.
- Automated FTP uploads and downloads to and from Payer sites.
- Secure transportation using SFTP and FTP over VPN and HTTPS.
- Dialup support.
- Dynamic creation of 997s.
- Trading Partner profile maintenance.
- Encryption using PGP and Zip with password for security.
- Reconciliation module to reconcile claims at various points of "electronic claim life cycle".
- Reports module for creating a variety of custom reports in PDF format.
- Payer, Provider, Claim and Service Line views and edits.
- Additional custom views can be added.
- Automated creation of PDF 'Explanation of Benefits' (EOB) reports as part of 835 processing.
- Audit trail and viewing.
- Command line version and automation.
- Additional steps in the claim life cycle management process can be built on demand.
- Online X12N Dictionary.
- expEDIum X12N Framework is used internally to perform seamless translations/encryption/transfers.
- Platform independent, Java based solution.
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Please Contact Us to discuss your specific requirements and you can request for a remote demo of this software from our website.
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