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The expEDIum Medical Billing Solution (eMBS) is a web based solution that allows complete medical claim life cycle management starting from data entry all the way to automated payer connectivity. This solution is HIPAA enabled, natively handles all data in HIPAA compatible formats seamlessly and securely1. This solution supports all typical processes of a billing operation. This solution provides a web based access to the providers or any other clients of a billing operation to logon to the solution and perform a variety of operations including reviewing the status of claims and creating/downloading different reports. This solution is a cost effective alternative for Billing Service Bureaus, Hospitals, Clinics and Healthcare BPOs. The expEDIum X12N Framework is used internally to perform seamless translations.
Note a variety of custom features can be added to this solution. Please Contact Us to discuss your specific requirements and to request for additional information about this solution
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The main features of our eMBS Solution are:
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| Key Features |
- Batch control and Workflow.
- Patient Master, Demographics.
- Primary and Secondary billing.
- ICD-9, CPT, HCPCS code lookups and validation.
- Exhaustive payer list and lookups.
- Customizable super bills.
- Standard healthcare form based data entry, validation, scrubbing.
- Handling of Paper claims.
- Handling of Electronic EDI claims.2
- Automated Staged posting.3
- Reconciliation module.4
- Eligibility Enquiries and Responses.5
- Claims Status module.6
- Customizable data edits and business rules.
- Privilege based access.
- Audit trail and Productivity reports.
- Reports module to create customized reports in PDF, CSV or HTML formats.
- Productivity enhancements that increase the billing efficiency.
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| Provider side access |
- Web based secure provider/client access.
- Provider side reports viewing and downloading.
- Provider side upload of legacy format files.
- Provider side claim scrubbing.
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| Automated Payer Connectivity |
- Extensible Payer Edits module.
- PGP and ZIP with password support.
- Direct Payer connectivity and multiple payer support.
- Dialup support.
- Standard Secure transportation mechanisms such as SFTP, FTP over VPN and HTTPS.
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| Technology |
- Open database and standard Internet browser support.
- Needs an Application Server such as JBoss.
- Platform independent, J2EE based scalable solution.
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1 expEDIum X12N Framework is used internally to perform seamless translations
2 837P, 837I, 837D
3 835
4 997 and 835
5 270, 271
6 276, 277
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