Claims System
Techcusp.com can help build - ground up & comprehensive, web-based claims management system. We can custom build claims system could for P&C Insurance, Workers Comp Insurance, Insurance Brokerage, Health Insurance, TPAs and Reinsurance firms. Claims Management System (CMS) will be designed to support all phases of the policy lifecycle, e.g., application processing, issuance, commissions, billing, audits, reporting, cancellations and reinstatements.
Browser-based multi-line system will be designed to support carriers, third-party administrators, public entities and self-insured organizations in administering claims for all lines of business. Its interface will be intuitive and easy to use..
- Affordable Care Organizations (ACOs)
- Auto Insurance
- Casualty Insurance
- Commercial Insurance
- Dental Insurance
- Employee Benefits
- Excess Lines Insurance
- General Liability Insurance
- Health Coop
- HealthCare
- Managed Care Organization (MCOs)
- Marine Insurance
- Medicaid (MMIS)
- Medicare
- Medicare Advantage (MA/PDP)
- MLTC
- PACE
- Pharmacy
- Private Health Exchanges
- Property Insurance
- Reinsurance
- Self-funded Plans
- Specialty Benefit Managers (SBM)
- Third Party Administrator (TPAs)
- Vision Insurance
- Workers Comp (WC) Insurance
- 360-degree view of customers/members
- Authorizations
- Automated Re-Pricing
- Benefit Administration
- Capitation
- Care Management
- Case Management for complex claims and processes like fraud and subrogation
- Claims Adjudication
- Claims Analytics - Dashboard
- Cloud / Web based
- Customer Service
- Data Warehouse
- Easy link to all external documents
- EDI Interfaces
- Eligibility / Enrollment
- Encounter Processing
- Fulfillment
- Group Administration
- HIPAA, ACA, PHI Compliant
- Integration with Workers compensation software, Policy Admin, Portal and HealthCare Systems
- Intelligent workflow
- Mail merge letter generation, PDF and state form filler, and design flexibility
- Member Management
- Mobile
- Multi-Client Support
- Network Management
- Open Source or Microsoft SQL database for simple
- Overpayment Recovery
- Pre-certifications
- Premium Billing
- Provider Contracting
- Provider Credentialing
- Provider Reimbursement
- Referrals
- Remote Accessibility & Confidentiality
- Reporting and Data Exports - Canned, Ad hoc, Statutory or Custom Reporting
- Rules based
- Secured
- Subrogation
- System wizards
- UM & Med. Management
- User Friendly Interface
- Web Portals
