Member and benefit administration
Maintain member records, plan relationships, coverage periods, limits, and benefit rules that inform eligibility and claim decisions.
eIntelliClaim Enterprise
Connect members, providers, benefits, and claims in one operational platform
A configurable platform for private insurers, TPAs, employer health plans, provider networks, hospitals, and managed care programs.
Platform overview
Make the claim lifecycle visible and manageable
eIntelliClaim Enterprise brings coverage, provider activity, review decisions, claim status, and reconciliation into a consistent operating model.
Provider network workflows
Connect facility users to verification, preauthorization, submission, correction, and status workflows with role-appropriate access.
Claims operations
Standardize claim intake, completeness checks, validation, reviewer routing, adjudication outcomes, and documented adjustments.
Reconciliation and reporting
Link approved claims with invoice and payment tracking while supporting configurable operational and management reporting.
Claims lifecycle
From verification to accountable payment tracking
Configure checkpoints around your products, provider agreements, operating teams, and approval policies.
Verify
Check member identity and active coverage.
Eligibility
Apply plan, benefit, and limit rules.
Preauthorize
Route defined services for approval.
Submit
Receive structured claims from providers.
Review
Validate data and assess exceptions.
Adjudicate
Record supported review decisions.
Reconcile
Track invoices and payment status.
Report
Monitor operations and utilization.
Audit
Preserve traceable user and claim activity.
Core capabilities
Configure the platform around your operating model
Eligibility and identity
Support coverage checks, identity verification, and benefit confirmation at the point of care.
- Member records
- Coverage periods
- Benefit controls
- Identity workflows
Preauthorization
Coordinate request, review, approval, and status processes for services that require prior authorization.
- Configurable routing
- Clinical context
- Decision history
- Provider status
Electronic claims
Replace inconsistent submissions with structured claim capture, validation, and correction workflows.
- Standardized intake
- Completeness checks
- Corrections
- Attachments where configured
Review and adjudication
Give claims teams the context and workflow needed to make and document review decisions.
- Rules support
- Exception handling
- Reviewer assignment
- Audit trail
Reconciliation
Track approved claims, invoices, adjustments, and payment status without losing the link to source activity.
- Invoice preparation
- Payment status
- Adjustments
- Provider visibility
Reporting and oversight
Support day-to-day operations and management review with configurable reporting outputs.
- Operational dashboards
- Utilization views
- Provider activity
- Exportable reports
Deployment and integration
Fit the platform into your architecture
Use secure APIs, configurable services, and batch or real-time exchange patterns according to the target environment.
Managed Cloud
Hosted and managed by Pillarsis with operational support aligned to the program’s requirements.
Customer Cloud
Deployed into a customer-designated cloud environment with agreed responsibilities and controls.
On-Premises
Installed within customer infrastructure or a designated data center where program constraints require it.
The appropriate model depends on program scope, data residency, security, integration, and operating requirements.
Bring your claims operations into one connected platform
Talk with Pillarsis about your program, provider network, current systems, claims workflows, and implementation priorities.