We applied our expertise as a payor to build an award winning claims processing system to help us manage our members, and we are confident it will help you manage yours.
With our specialized globalcentara Payor technology, we help you focus back to membership growth, health maintenance and a positive return on investment.
Flexible, web-based monthly subscription service is based on the number of users
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Scalable for your company's growth and needs, can fit any health plan size from small to large.
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All you need is a PC and an internet connection to log on.
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No upfront capital costs or server purchases.
Reduce overhead costs
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Built-in intelligent rules based engine re-prices or auto adjudicates claims without manual intervention.
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Processes payments for all types of provider contract rules and exceptions, flexible and efficient.
Increase workflow management
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Integrated Microsoft® BizTalk Accelerator for HIPAA to handle all electronic medical transactions mandated by the government. Eliminates the cost of a third party clearinghouse.
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Built-in member services, tracking and benefits management.
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Built-in premium billing.
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Built-in credentialing, UR, case management, clinical protocols that utilize reportable, stored database fields.
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Built-in Web Portal to allow providers and members to access claims status, eligibility or pre-cert.
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Capitation processing/eligibility roster management. Process sub-cap for providers.
Integrated digital dashboard and reporting
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Digital Dashboard allows you to manage the critical information to analyze your business and predict trends, thus reducing your overhead costs and resetting your focus on your membership.
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Flexible web-based reporting through Cognos® - create your own ad hoc reports via simple drag-and-drop menus in real time from anywhere. Warehouse, integrate and analyze your data.
