The expEDIum Medical Billing is a web based secure Medical
billing solution that has a variety of features including
provider side web based secure access and high performing
backend expEDIum Claims Portal Components.
This solution is an optimal way to allow Practices, IPAs,
Billing Services and Hospitals to do the billing and to connect
to one or more Payers or Clearinghouses directly, make the
claim life cycle more transparent and to make the claim management
more efficient and predictable.
This solution supports a standard set of Medical Billing features and beyond. This solution is available in SaaS (Software as a subscription) "mega-tenant" model for monthly subscription.
Key Features
Multiple account support, each account can be a Practice or a Provider.
Automated population of provider data from account setup to reduce data entry
Patient Demographics
Patient Ledger
Patient Statements
Primary and Secondary billing, Automatic population of COB data on Secondary claims
ICD-9, CPT, HCPCS code lookups and validation (ICD-10 support will be available soon)
Taxonomy code and NPI lookups
Online validation and scrubbing
Standard healthcare form based L1, L2, L3 validation, a level of L4 to L7 validation
Rule based automated and manual routing/creation of Electronic or Paper claims
Exhaustive payer list, lookups and Payer ID validation
Multiple Trading Partner Profiles/Multiple Carriers
Printing of Paper claims on stationary
Automated creation of Payer Ready Electronic EDI claims (currenly v4010A1 is supported, v5010 support will be available soon)
ERA/EOB automatic/manual posting and reconciliation
Automated processing and claim level reconciliation of delayed payer reports - both standard (such as TA1, 997, 277U, 824, 864, 835) and non-standard reports from Clearinghouses and payers
Automatic/manual cross-over of secondary payment posting and reconciliation
Account specific ERA/EOB creation
Denial Management
Claim History and Claim Tracking
Data Archival of aged batches, claims and other data
Customizable data edits, payer edits and business rules
Message based communication with users from Portal Administrator
Customizable Administrator and Provider dashboard showing a summary from the system
Reports include Practice Analysis, Insurance Analysis, Activity Summary and A/R reports.
Collection Report
Monthly Biller Invoice creation from administrator module
Customizable Reports module
Secure Web services interface with SSL authentication and encrypted login
Near Real-time and batch level Eligibility Enquiry/Response
Production driven, High performance, scalable solution
Client side access
Web based secure provider/client/operator access
Account Password expiry
Customizable Dashboard
Customizable Reports
Currently deployed to handle specialties such as General, Chiropractic, Podiatry, Physical Therapy and Ambulance claims, capable of handling any specialty claims with no or minor changes or with minimal edits. Please contact us with any specific requests
Automated Payer and Clearinghouse Connectivity
Automated upload of HIPAA compliant, payer ready claims to configured payers and clearinghouses
Automated download of payer side reports including TA1, 997, 277U, 824, 864, 835 and non-standard reports
PGP (RSA & Diffie-Hellman) and ZIP with password support
Standard secure transportation mechanisms such as SFTP and FTP (FTP over VPN, HTTPS and Dialup will be available soon)
Technology
Platform independent, J2EE based scalable solution
Needs an Application Server such as JBoss, Websphere or Glassfish
Uses PostgreSQL, a robust and reliable open-source relational database system, portable to other DBMS
Tested in OS platforms like Windows 2003 Server, Solaris and Linux distributions such as Redhat, Fedora, Debian and Ubuntu
Please request for a remote demo of our expEDIum Medical Billing solution.
