Our software has been providing solutions for the medical industry since 1986. Our software is a collection of interface products dealing with the management of electronic medical claims which improves operational efficiency and productivity.
Our interface products are powered by our DaFoDiL™ data format description language, allowing for customized processing for each provider. Currently the DaFoDiL™ language will read information from any form, record or X12 format. Examples of such formats include HCFA 1500 and UB92 print formats, NSF record formats, HIPAA 837 X12 formats, and proprietary formats such as UNILAB Tab Delimited or your provider’s favorite Excel spreadsheet.
The Claims WorkBench™ system provides a permanent, searchable copy of all electronic claims submitted to you. You may search by patient name, provider account number or submitted member ID. Claims can be viewed in their original format on-line and printed to paper. There are no questions about what was submitted, because you have a permanent copy of the data.
The CWB-Router™ work flow system part of the Claims WorkBench™ system provides a means of directing claims into multiple queues and identifying claims that need to be reviewed manually. Initial queues in this claims work flow manager can be determined by a series of business rules. Some of the queues can require manual claim review to determine the final queue.
The Claims-2-eLoad™ system has been improving claims processing efficiency since 1993. Rates often exceed 8,000 claims per day per user. The Claims-2-eLoad™ system translates multiple claim formats using our DaFoDiL™ language, as well as providing claim filtering, data conversion and verification, member ID correction, editing, and complete audit trails.
The Claims-2-Payer™ system extracts data from your claim system and formats it for delivery of claims information to payers. Using the DaFoDiL™language, the Claims-2-Payer™ system provides an easy means of complying with each payer’s unique interpretation of HIPAA 837 specifications or their own proprietary encounter formats.
The What’s HIPAAning™ guide is for Claim files in the HIPAA 837 format. 4010/5010P indicates professional and 4010/5010I indicates institutional.