expEDIum Medical Billing

The expEDIum Medical Billing is a web based secure Medical billing solution that has a variety of features including provider side web based secure access and high performing backend expEDIum Claims Portal Components.

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Specifications

Details

The expEDIum Medical Billing is a web based secure Medical billing solution that has a variety of features including provider side web based secure access and high performing backend expEDIum Claims Portal Components.

This solution is an optimal way to allow Practices, IPAs, Billing Services and Hospitals to do the billing and to connect to one or more Payers or Clearinghouses directly, make the claim life cycle more transparent and to make the claim management more efficient and predictable.

This solution supports a standard set of Medical Billing features and beyond. This solution is available in SaaS (Software as a subscription) "mega-tenant" model for monthly subscription.

Key Features

* Multiple account support, each account can be a Practice or a Provider.
* Automated population of provider data from account setup to reduce data entry
* Patient Demographics
* Patient Ledger
* Patient Statements
* Primary and Secondary billing, Automatic population of COB data on Secondary claims
* ICD-9, CPT, HCPCS code lookups and validation (ICD-10 support will be available soon)
* Taxonomy code and NPI lookups
* Online validation and scrubbing
* Standard healthcare form based L1, L2, L3 validation, a level of L4 to L7 validation
* Rule based automated and manual routing/creation of Electronic or Paper claims
* Exhaustive payer list, lookups and Payer ID validation
* Multiple Trading Partner Profiles/Multiple Carriers
* Printing of Paper claims on stationary
* Automated creation of Payer Ready Electronic EDI claims (currenly v4010A1 is supported, v5010 support will be available soon)
* ERA/EOB automatic/manual posting and reconciliation
* Automated processing and claim level reconciliation of delayed payer reports - both standard (such as TA1, 997, 277U, 824, 864, 835) and non-standard reports from Clearinghouses and payers
* Automatic/manual cross-over of secondary payment posting and reconciliation
* Account specific ERA/EOB creation
* Denial Management
* Claim History and Claim Tracking
* Data Archival of aged batches, claims and other data
* Customizable data edits, payer edits and business rules
* Message based communication with users from Portal Administrator
* Customizable Administrator and Provider dashboard showing a summary from the system
* Reports include Practice Analysis, Insurance Analysis, Activity Summary and A/R reports.
* Collection Report
* Monthly Biller Invoice creation from administrator module
* Customizable Reports module
* Secure Web services interface with SSL authentication and encrypted login
* Near Real-time and batch level Eligibility Enquiry/Response
* Production driven, High performance, scalable solution

Client side access

* Web based secure provider/client/operator access
* Account Password expiry
* Customizable Dashboard
* Customizable Reports
* Currently deployed to handle specialties such as General, Chiropractic, Podiatry, Physical Therapy and Ambulance claims, capable of handling any specialty claims with no or minor changes or with minimal edits. Please contact us with any specific requests

Automated Payer and Clearinghouse Connectivity

* Automated upload of HIPAA compliant, payer ready claims to configured payers and clearinghouses
* Automated download of payer side reports including TA1, 997, 277U, 824, 864, 835 and non-standard reports
* PGP (RSA & Diffie-Hellman) and ZIP with password support
* Standard secure transportation mechanisms such as SFTP and FTP (FTP over VPN, HTTPS and Dialup will be available soon)

Technology

* Platform independent, J2EE based scalable solution
* Needs an Application Server such as JBoss, Websphere or Glassfish
* Uses PostgreSQL, a robust and reliable open-source relational database system, portable to other DBMS
* Tested in OS platforms like Windows 2003 Server, Solaris and Linux distributions such as Redhat, Fedora, Debian and Ubuntu

Please request for a remote demo of our expEDIum Medical Billing solution.

Tags

SaaS Solution, HIPPA EDI Solution, medical billing, Insurance Billing, Automated Billing, Electronic Claims, Claims Processing, IPAs, MSO, Hospital, medical software, HCFA-1500, CMS,UB-04