The Challenge

The payor was spending more and more on clearinghouse services, and did not have a system that would allow for real-time connectivity with their claims adjudication platform. They wanted to cut down on customer service calls by providing information through a self-service portal.

The Solution

With Novus 360 Benefits Admin Software, the payor was able to have a customized API that directly pulled data from their claims system and relayed it via the clearinghouse and viewable on an online real-time portal. This saved dentists valuable time and helped manage the payor’s call volume.

The post Enhancing Electronic Data Interchange appeared first on Comp Health Care.

The Challenge

The fund was processing over 13,000 claims a year, with an average of 30-60 minutes spent manually processing each claim. Their staff had to manually input reimbursement documentation, receipts, forms, and more. The process was labor-intensive, costly, time-consuming, and prone to errors.

The Solution

With Novus 360 Benefits Admin Software, these claims are now automatically distributed.  Claims processors simply need to adjudicate the claim, reducing the processing time by 75% to an average of 7 minutes per claim!

Additionally, wait time for member reimbursements has been reduced tremendously. Before, it could take 2-3 weeks or longer to receive a  payment. Now, these reimbursements are completed within 1-4 days. Many get adjudicated the same day and paid out in the same week.

“…both our staff and members have had better, happier experiences since we started using Novus 360 as we able to close the claims faster…”

The post Streamlining A Health Fund appeared first on Comp Health Care.