Seamless Licensing Solutions:
Effortless Claim Processing with Guaranteed Data Security – Explore Our Licensing Options
Software as a Service (SaaS)
Using this method, claim shops can FTP their claims to our server where it will be picked up, processed and sent back within in a matter of minutes. Our data center is SSAE 18 Type II (SOC2) certified and HIPAA compliant. Our agreement does not contain any tricky “evergreen” clauses and our clients can cancel at any time.
Software Licensing
Our copyrighted proprietary software is available for licensing to those organizations whose claim systems reside on IBM’s AS/400, iSeries and IBM i platform. Existing interfaces are available for MC400®, iBenefits® and powerMHS®.
User Definition
Among the unique features of OaRS for IBM i is its ability to let the user customize the examination of their claims. The most popular customization feature is the user’s ability to sequence the order in which the edits fire. Another popular customization feature is its flexibility in identifying duplicate claims. Most systems define duplicates as claims that have the same procedure, performed on the same patient on the same date by the same provider. Not with OaRS, because we leave the definition of duplicates entirely up to you. Our software allows you to define a duplicate by the use of nearly two dozen different selection criteria. For instance, in order for a claim to be considered a duplicate, must the billed charges be the same on all potential duplicate records or can they be within a certain variance of, say, 15% of each other?
Automatic Reprocessing
Included in the system is a module that allows you to reprocess all of the duplicate claims that are discovered. This permits you to automatically reverse duplicates that have already been paid and gives you the ability to pend or deny claims that are waiting to be paid.
In Good Company
Our system is installed at many health plans, TPA’s and self-insured plans around the country.
AS/400, iSeries and IBM i are trademarks of International Business Machines. MC400 and iBenefits are trademarks of ITEL, Inc. powerMHS is a trademark of DST Systems.