e-Claims and e-Payments

The E-claims module provides online eligibility verification as well as both real-time and batch claims submission and adjudication. The system has been designed for the requirements of Caribbean jurisdictions and is operational with the healthcare providers in the Cayman Islands where hospital and physician office staff use the on-line eligibility verification portal not only to verify patient coverage, but to ascertain levels of patient financial responsibility in the transactions. This allows them to collect co-payment balances on the spot eliminating the need for balance-billing.