|
Outsource Advantage of Greenville, SC has interfaced their E-Net/2020 product with CAPS/2020. E-Net/2020 allows employees and physicians to view eligibility and claims information through the Internet. This product also allows for on-line enrollment.
Emdeon of Nashville, TN has interfaced their Mailroom Outsourcing product with CAPS/2020. Emdeon uses a data extract module to provide the necessary raw data for processing into mail documents—checks and EOBs. From this raw extract, Emdeon constructs customized document output, consolidates mail to the same addresses, and uses proprietary mailroom technology to eliminate excess labor, sorting and commingling fees. This saves the typical client over $100,000/year. Finally, Emdeon dramatically helps the TPA cut costs associated with hard copy print and mail operations resulting in savings of $250,000 or more per year.
ComCom Systems of Clearwater, FL has developed an imaging system, which will scan documents directly into the CAPS/2020 system. This will dramatically decrease the time spent inputting the mail. Their system will also allow for Internet access to scanned documents.
Extol of Franklin Lakes, NJ uses their EDI Integrator package to pass information electronically into the CAPS/2020 system. Their package allows for the mapping of all ANSI and proprietary information coming in from clients all around the world.
Ingenix of Salt Lake City, UT has various Usual, Customary and Reasonable (UCR) Fee schedules that enable the CAPS/2020 system to automatically reduce payments. They also have authored the Claims Edit System (CES), which prevents inappropriate billing practices, such as unbundling, missed multiple frequency discounts, billing for follow up days, etc. CAPS/2020 will process claims against the CES system sending all errors to an examiner for further review. Claims that are clean can be sent for automatic payment without any further human intervention.
Ohio Data Transfer of Columbus, OH has integrated their Voice Response and Fax Units with CAPS/2020. Now an employee or provider can inquire 24 hours a day regarding employee eligibility or the status of a claim.
MAPSYS of Columbus, OH is the IBM hardware and software integrator for CAPS/2020 customers. The IBM iSeries computer is a MAPSYS specialty. They have a team of certified professional specialists providing help with cost justification, solution planning, application development, implementation services, training, support and financing.
SIEBA, Ltd., of Endicott, NY uses their Laser/2020 product to produce all in-house checks and EOBs for the CAPS/2020 system.
Preferred Medical Claim Solutions, (PMCS) of Scottsdale, AZ, is the proven "Leader in Claim Settlement, with the nation's first and only Advance Funded Provider (AFP) program. Clients of PMCS have access to a cost containment solution that seamlessly incorporates into their daily claim processing routine. Founded in 1998, PMCS established a Preferred Data Interchange (PDI) between Payors and Providers to facilitate the processing of medical claims that were deemed eligible, but were submitted by medical providers not associated with the Payors primary network. PMCS continues to be a progressive partner in the healthcare industry with its services proven to efficiently reduce paperwork, disputes and the time it takes to render payment for services. By automating and streamlining the claim settlement process, PMCS has enabled its business partners to save millions of dollars.
Evolution Benefits,Inc. is the industry leader in electronic benefit payment solutions for the employee benefits market. Its primary product, the Benny™ Prepaid Benefits Card, applies advanced payment and patented auto-substantiation technologies to health-related benefits accounts such as Flexible Spending Accounts, Health Reimbursement Arrangements, and Health Savings Accounts. Evolution Benefits’ auto-substantiation technologies were patented in 2007 and other patents are pending. The company now powers the programs of more than 225 administrative services organizations and covers more than 14,000 employers, including over 130 of the nation’s top-ranked Fortune and Forbes companies.
The CAPS/2020 Technical Support Center in Fort Worth, TX, provides telephone support 24 hours a day and on-site training for all CAPS/2020 users.
These business partner relationships position the CAPS/2020 system for the "paperless" 21st Century. Only "problem" claims need to be reviewed; all other claims can pass directly from the electronic input stage to the electronic output stage without human intervention or the generation of printed documents.
|
