MANAGING INSURANCE
Glide through the complexities of today’s health insurance environment with the robust Managing Insurance component of Management & Billing. Information is linked to key data throughout your system, enabling your medical practice to manage, track, report…and save time.
Insurance connections
- Information on insurance carriers is linked to data on employers, benefit
limits, co-pays, patients, authorizations and referrals.
- Allowed schedules are connected to provider participation and identification numbers.
- If data needed is not in the system, you can add it “on the fly,” then
easily access it from different locations within the system.
Insurance power
... all this and more from Managing Insurance:
- Maintains the parameters established for an insurance plan and/or carriers
- Monitors and tracks patients within the network of insurance plans
- Ties capitated and insurance payments to the insurance payers and the care plan
- Records benefit plan limits by employer
- Offers reporting flexibility to view plans in the way you wish: individually or as a group, in detail or summary
- Makes automatic adjustments for services covered under capitation
- Calculates discounted and withhold amounts during posting of payments
- Scan the EOB and it becomes part of the patient record, ready for retrieval when needed. Submitting EOBs with claims to secondary insurance? Just hit “print” and your copies are ready.
- Scan the EOBs and they are automatically stored by insurance company, by posting date, and by check number
Provides detailed reports to track and analyze the performance of specific care plans
Insurance control
- Track referrals in and out of the practice
- Compute patient co-pay amounts that can be collected at check-out
- Track physician status with an insurance carrier
- Set your own parameters for each care plan
- Establish databases of the contracted allowed fee schedules, network insurance payers, employers and plan benefit limits
- Print insurance member lists, capitated and non-capitated patients
- Produce a comparison report on a physician’s production based on relative value units
- Compute what your fee schedule should be, based on multipliers you enter into the system
Insurance reports
Choose from a wide variety of reports, then customize the information to suit your medical practice:
- Care plan patient list
- Discounted accounts receivable summary
- Discounted transaction summary analysis
- Care plan evaluation
- Visit volumes
- Employer visit volumes
- Relative value units
- And more ...
Expand the power of Managing Insurance. Just add PDS Cortex’s optional Electronic Remittance Distribution module and experience the streamlined world of electronic insurance payment posting.
READY TO TALK?
Call us today to schedule a PDS Cortex demonstration!
1-800-283-7543
sales@pdsmed.com