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TI Instream®: Real-time transaction management
equals real-world success
The good news: Since 2002, the number of claims
adjudicated without manual intervention has risen dramatically,
to a national average of 68%¹.
The bad news: It costs over 140% more to process
a pended claim than a clean one². So, even if your first pass
rate is well above the average, these pended claims are costing
your organization hundreds of thousands of dollars each year.
Why are Foresight customers happy with
TI Instream?
Because customers helped us design TI Instream,
it does exactly what you need it to do. Instream offers a unique
approach to claims transactions by helping you overcome some of
the key challenges your organization faces:
- One noncompliant claim ruining processing of the rest of the
batch
- Transmission of bad data that results in costly mispaid claims
and a torrent of angry provider calls
- No notification of problems (to peers or to partners) until
it’s too late
- Little understanding of what went wrong or how to ensure it
doesn’t happen again
- Limited visibility into claims operations or trends that could
enable you to attack the larger issues
How can TI Instream
help me?
Instream enables business managers across your
organization and among your partners to capture business intelligence
about critical transactions and act upon it immediately, because
details about the transaction process are visible, beginning to
end. You will be able to:
- Protect your adjudication systems against missed errors, mispaid
claims and mishandled adjudication.
- Stop the transmission of bad data while speeding good data ahead
- Provide early, quick notification of problem transactions so
providers can self-correct
- Ensure rapid response to crises with automatic initiation or
suspension of tasks through a proactive alerts system
- Use dashboards to get real-time access to critical business
performance indicators: volumes, success rates, and top errors
- Monitor, monitor, monitor: Exception alerts, transaction auditing,
and menu-based dashboards allow real-time monitoring of operations,
trend identification, transaction tracking, and problem investigation
and resolution.
What can Instream do?
Instream is built on the world’s fastest
single-pass claims validation engine, so it ensures compliance of
inbound and outbound data based on industry standards, organizational
guidelines and specific business rules. Specifically, it offers:
- Transaction Validation & Filtering based
on HIPAA, WEDI level 1-7, front-end and pre-adjudication edits.
And now, validate beyond EDI to include XML and Flat File formats
– allowing you to work with Claims with Attachments, proprietary
format Enrollments, and more.
- Intelligent Data Routing of data based on transaction
type, file properties, error type, and more, allows you to streamline
processing and avoid bottlenecks.
- Transaction Editing of data through high-speed
data swapping, field mapping and on-screen display of data (formatted
(just like its paper-based counterpart!)
- Business Activity Monitoring for you and your
business partners through dashboard data presentation and proactive
alerts, providing the ability to identify and address trends quickly.
- Advanced Workflow Control including: scheduling,
polling, file transfer, transaction translation, validation, event
triggers, and statistics in a “drag and drop” workspace.
Remote Activity Control capabilities allow you to design processes
and run them on multiple machines.
- Complete Integration with third party components
and APIs.
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.
¹,² - Source: AHIP Center for Policy and
Research
Instream is a registered trademark of Foresight
Corporation
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"Instream paid for itself the first year we had it"- Foresight healthcare plan customer.
For more information:
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