Medical Claims Processing Software for United States

Benefit Administration System basically divided into two parts one is eligibility another is claim processing. The second part for Medical Claims is designed to capture, verify and route medical claim data to adjudication systems without manual data entry. The software solution is pre-configured to capture every field from Professional claim forms used by individual medical providers or suppliers, and from Institutional claim forms used by institutional providers such as hospitals.

Medical Claims eliminates costly, error-prone manual data entry and accelerates claim processing and delivers claim data to adjudication systems in the HIPAA-compliant 837 data format.

  • Improve claim data accuracy
  • Reduce data entry cost
  • Speed claim processing time
  • Aid HIPAA Compliance
  • Maintain your business workflow
  • Enable easy work distribution

Key Features

BAS for Medical Claims was the first software solution designed specifically for medical claim processing. HMO's, Blue Cross Blue Shield Organizations, Preferred Providers and Third Party Administrators nationwide have used BAS for Medical Claims to double or even triple their data entry productivity.

Workflow Flexibility

Rules provide maximum flexibility over the sequencing of all phases of the capture process, including image processing, page ID, recognition, applying business rules for validation, and export formatting.

Easy Interface Enhances Productivity

The single-pass, modeless data entry and verification interface enables verifiers to skip directly to uncertain characters or invalid fields all with a single keystroke.

HIPAA Compliant

Medical claim processing with BAS for Medical Claims ensures that your organization meets legislative requirements. EDI output is HIPAA compliant and access levels ensure privacy.

Automatic Validations

Recognized data is automatically validated through look-ups, comparisons, math, or customer-specific rules. Look-ups include Provider, Member, Diagnosis, Procedure and POS. Addresses and telephone numbers are validated with a Zip Code lookup and logical date comparisons ensure that the Date of Service is accurate.

Easy Work Distribution

With the addition of BAS Web, scanning or verification can be performed in a browser for easier administration or for remote capture. All validation rules run in a browser so there is no additional management overhead when distributing claims processing work.

Low Cost of Ownership

BAS for Medical Claims uses a concurrent licensing model with no dongles or pay-per-click pricing. Designed specifically for medical claims and with full browser support, BAS for Medical Claims is easy to deploy, learn and manage.

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