ikaCLAIMS

Achieve New Levels of Operational Efficiency and Transparency

ikaClaims delivers rapid and automated administration of claims for both group and individual commercial business lines as well as Medicare and Medicaid products — all in one system.

ikaClaims delivers:

• Agility and flexibility: ikaClaims helps you rapidly and easily configure highly granular benefit plans and provider contracts. All system components and business rules can be user-defined, from the most basic to the most specific level of detail. You can also utilize ikaClaims’ pre-loaded benefit categories, pre-loaded fee schedules and standard/system codes to effortlessly incorporate custom benefit plans and respond quickly to changing market demands. As a result, health plans can achieve average auto-adjudication rates greater than 90 percent, typically within 3 months of go-live.
  
  
• Interoperability: User-friendly Web-based access and integration with other Web-based applications make it easy to share processes and information internally as well as externally, facilitating key business initiatives such as transparency and collaborative care management.
  
  
• HIPAA compliance: ikaClaims accepts and produces all HIPAA-compliant transaction code sets (834, 270, 271, 278, 837, 276, 277, 835, 820). In addition, multiple security levels are possible using role- and rule-based access configurability.
  
  
• Accuracy: With exceptionally high auto-adjudication rates, ikaClaims virtually eliminates the need for manual intervention, resulting in consistent, accurate claims payments.
  
  
• Efficiency: With ikaClaims, you can easily manage referrals and authorizations, as well as take advantage of automated correspondence and other customer service tools to reduce the time staff need to spend on routine activities.