Skip to main content

TPA Software Revolutionizes Administrative Processes in Healthcare Claims Industry

TPA Software automates workflows & claims to handle tasks that enable you to introduce a level of auto-adjudication to your claims process, this particular functionality makes sure that the claims process is settled in a systematic manner doing the right thing at the right time. The claims processing software minimizes reliance on manual processes increases productivity and efficiency, and decreases the probability of human error throughout the claims process.

The TPA Software calculates payments based on the claim, policy and benefits information provided. Whether you want to combine payments set up automated scheduling, the software is designed to meet all your requirements to handle claims management & obtain streamlined workflows, quick access to claims history, and advanced claim adjudication with electronic processing.

DataGenix ClaimScape TPA Software allows third-party administrators to gain effective cost-savings and predictable ROI by replacing legacy claims & benefit administration systems. It provides TPAs with modern administrative processes by offering a centralized platform solution to streamline workflows & track benefit plans,  offer a real-time interface with context, and core administrative processes.


Full Dental Claim Support & Visual Tooth Chart

It’s integrated “Claims Processing Software & Benefits Administration" delivers the dental, vision as well as administrative payer platform that further provides a competitive edge that you need for cost-effective administration.  

TPA Software from DataGenix helps reduce the workload of TPAs and offers responsive portal access capabilities to allow members, providers, and group administrators to connect, communicate and share data in real-time. It provides detailed symptoms and daily level of care tracking, track referrals, pre-authorization, and complete hospital stays.

The claims processing software offers full support for the non-standard and custom hospital and clinic coding, support claims payment to members and providers via Nacha Bank EFT File. It ensures the users stay in touch with modern technology to provide long-term value for existing clients while helping you with new business.

Streamlined Customer Servicing with Multi-Window Support

DataGenix TPA Software delivers streamlined customer servicing with multi-window support along with the process of automated claim adjudication, automated online enrollment, advanced correspondence logging with one-click links to the original document, one-touch access to plan docs, claims and handy correspondence tracking and pop up notes and reminder system.

The “Customer Servicing” application also provides customer service call and correspondence, SMS or Email to response to callers, on-screen phone log and customer service queue, route to supervisor capability, advanced correspondence logging with one-click links to original documents, instant links to word, excel and outlook with auto-fill letters and correspondence, auto-generated letters with Microsoft word integration and red card support.
Labels:
Location: 5225 Canyon Crest Dr Suite #357, Riverside, CA 92507, USA

Comments

Post a Comment

Popular posts from this blog

Emerging Trends In Healthcare BI Solutions For 2025 & Beyond

As someone deeply involved in healthcare, you understand the need to balance quality care with operational efficiency. By 2025, healthcare business intelligence solutions are set to transform how you achieve this equilibrium. The systems take in massive amounts of data that you handle every day and convert them into strategies that improve your work. Now, let us explore the trends shaping this field and how these can help you achieve your goals. Why Data Matters More Than Ever to You Your days are filled with information—patient files, payment records, and staffing details. Left unmanaged, it’s a challenge to make sense of it all. Healthcare business intelligence solutions change that by sorting and interpreting this flood of facts. They show you where improvements are possible, helping you refine processes and prioritize patient needs. In an industry where precision is critical, this clarity gives you a competitive edge. Trend #1: Streamlining with Claims Management Software A major ...
Post a Comment
Read more

What Features To Look for In Modern Claims Software?

  Whenever they hear the word “claim,” everyone thinks of hustles, a large number of documents, and hundreds of identifications and proofs. The frustration is real. The complex world of traditional claim management often comes with multiple obstacles including manual procedures, lengthy claim settlements, and less transparency.  With digital transformation, claims managers can utilize predictive and generative Cliams management software to make decisions faster and automate claims processes.  They can easily operate tasks such as assignment, reporting, and settlement that will simplify the claims process and its efficiency.  If you're considering adopting or upgrading your claims management software, here are the key features you should look for to ensure it meets the evolving needs of your business. User-Friendly Interface Any modern Claims Software should offer an intuitive, easy-to-navigate user interface (UI). Whether you're an insurance agent, claims adjuster,...
Post a Comment
Read more

Processing Fraud Claims Made Easier with Third Party Claim Administrator

HSAs have been around for a while, but many small business owners are unclear about their purpose and implementation. As a small employer, you likely have a hundred different tasks on your mind to keep your organization running smoothly. This can make administering your employees’ health benefits, like a health reimbursement arrangement (HRA), just another task to add to your never-ending to-do list. Third-party administrators or TPA software can administer your health benefits-including your HRA-so you can concentrate on the more important aspects of running your business. TPA’s can save you money on administration, freeing up cash that could be better spent elsewhere. Understanding The Role of TPAs TPA’s are companies that specialize in claim payment processing for several other types of companies, including insurance companies, employee benefit plan providers, and third-party administrators. The TPA is not an insurance company or a health plan, but rather an organization with the ...
1 comment
Read more