TI Claims Manager

As part of the Transaction Insight (TI) Healthcare Suite, TI Claims Manager gives you the power to process millions of claims and manage each from receipt to payment quickly…easily…automatically. So you can:

Improve Provider Relations

• Accelerate adjudication
• Reduce provider calls
• Allow providers access to online portal for self-correction of data

• Speed claim research, repair, and resubmission
• Reduce Administrative Costs
• View detailed reporting from Enterprise reporting to transactional details
• Split and route claims to the appropriate back-end systems

How it works:

TI Claims Manager uses the industry’s highest performance validation engine to ensure compliance of healthcare claims transactions (837 and 27X) with HIPAA level 1-7 edits and your own business rules.

Data Splitting - By splitting allowing good transactions to flow forward to adjudication, while keeping non-compliant transactions from reaching your back-end applications, you keep auto-adjudication rates high, and pended claims low.

Data Correction – Incorrect transactions can be corrected in-house, or routed back to the submitter for correction through the secure online web portal.·

Reporting - Transaction Insight’s reporting capabilities are unparalleled. At the enterprise-level, you can manage your business with activity trend reporting activity across multiple adjudication systems. Managerial “Top 10” reports show the most common error types and causes. Transactional detail is presented in easy-to-read form-based format. And proactive error alerts let you know when user-defined events occur or processing thresholds are passed. The result is total real time visibility for transaction processing.

This fully configurable solution:

• Enables full claims management by providing greater visibility into claims processing (based on 837 and 27x transactions) including statistical analysis of error sources, volumes, trends, & benchmarks.
• Streamlines claims operations by providing proactive alerts that monitor partner activity and informs the payer and/or submitter about significant processing errors
• Reduces claims-related expenses by providing robust, no-surprises management of claims process (validation, routing, reports, alerts)
• Speeds adjudication by parking bad claims at the front end and sending clean claims through immediately for processing
• Drives down personnel costs using automated partner communication and simple, flexible definition and amendment of validation rules

Learn more about Transaction Insight, the complete e-commerce solution for healthcare, available from Foresight. Call 888-500-0800, or click here to have us contact you.

 
Downloadable PDFs

• TI Claims Manager Brochure