- Insurance bill estimation
- Generation of Preauthorization forms
- Registering OP / IP patients with Insurance Company and TPA details
- Capturing Pre-authorization amount and the way pre-authorization is received
- Capturing Insurance card image in registration
- Edit / Change Insurance company details and Pre-auth approval amount from Billing/Registration
- Automatic Calculation of Rates for different Insurance Plans
- Facility to split the item amount into the Insurance and Patient co-pay
- Advance/Refund option for patient payments
- Sending the claims to TPA's as Single Claim / Claim Batch
- Facility to mail the clinical and supportive documents through mail directly from Patient Medical Records to TPA's
- Tracking the Payments / Dues from TPA's using Reports
- Facility to record receipts from insurance/corporate sponsors using Claim Batch number or individual claim number with TDS preferences
- Pending Age Reports analysis to increase efficiency.
- Audit Log
- XML based Claim Processing as per specs of HAAD (Health Authority of Abu Dhabi) and DHA (Dubai Health Authority)
- Coding of various services provided in hospital. Supports CTP codes, HCPCS codes, DRG codes, ICD codes, Dental codes, LOINC codes, etc.
- Remittance Upload and Reconciliation / Entering the Payments using Claim Batch number or individual claim number.
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