Provider Portal Features
Transaction Capabilities
- Eligibility verification
- Member benefit verification
- Preauthorization submission and approvals
- Claims submission and status
- Claims tracking
- Referral submission and approval
- Submit a complaint
- Submit contact information changes
Electronic Medical Records
- Member profile management
- Member health history
- Diagnosis and test reports sorted per specific test and/or
time
- Download and upload medical reports
Inquiry Capabilities
- Plan benefits
- Benefit limitation status
- Patient search
Provider Portal Benefits
Improves the Efficiency of your Providers
- Instantly view current patient eligibility
and benefit information
- Reduces bad debt for services provided to ineligible
patients
- Billing staff can perform administrative work (eligibility,
claims tracking, etc) during off hours
- Receive authorization and referral approval in real time
- Frees phone lines by eliminating eligibility and
claims status calls
- Prevents incomplete claims from being submitted
- Correct claims errors before submission
- Routine authorizations and referrals approved electronically
using your business rules
- More complete claims result in faster average turnaround
Reporting Capabilities
- View provider performance against established benchmarks
- Providers can view complete claims history of their patients
(if authorized) improving the care received by your members
- Online status of broker/agent commissions, client premiums
and bills empowers your sales force to monitor their clients.
|
|
|
