Intelligent membership and benefit database that is updated in real time.
Reduce fraudulent claims through real-time membership authentication and benefit verification at the point of care.
Biometric authentication option that ensures only your members receive services at the point of care.
Intelligent claim workflow which allows for electronic routing of medical claims from and back to providers.
Reduce number of claims and increase revenue using proprietary big data analytics engine.
Big data analytics tools to send condition-based and targeted communications aimed at overall health and wellness improvement of members.
Manage health facility drug and consumable inventory that is updated in real time
Patient encounters that form the permanent record for the patient for future tracking and reporting.
eIntelliClaim makes it easier for providers to prepare and submit medical claims electronically. It significantly cuts the time it takes for insurers to process claims, reduces errors, reduces medical claim fraud and ultimately leads to cost savings to insurance companies.
To ensure only insured members receive care, all members are biometric-authenticated at the point of care before any service is rendered or claim is initiated.
Members are then checked for benefit eligibility to ensure that they get only those services they are entitled to. For insurers that impose a spending cap on their members, benefit amounts will be enforced before any service is rendered.
Once providers have completed a claim, it is automatically picked up and submitted to the insurer for processing and payment. The insurer will never have to manually enter claim data into their system. eIntelliClaim takes care of that!
Late payments and claim denials due to lack of member eligibility authentication and benefit verification which may also lead to an increase in insurance fraud
The paper-based process is costly, time consuming and extremely prone to human errors as the claim forms are filled out by providers.
Confusion that comes with healthcare providers having to use multiple paper claim forms and medical coding systems to submit medical claims; increasing chances of errors during claim preparations and submissions.
As errors are identified, corrections have to be made and claims resubmitted by paper, adding more to processing time before claims are adjudicated.As errors are identified, corrections have to be made and claims resubmitted by paper, adding more to processing time before claims are adjudicated.
Reduction in fraudulent claims due to real-time member benefit and biometric verification
Reduced claim management cost and time, more organized claim data, improved accounting and access to claims information
One integrated system which seamlessly connects with major payers eliminating the need for a multitude of payer-specific claim forms
Built-in claim workflow which allows for electronic routing of medical claims to/from providers in case corrections are needed.