Health Care
Enrollment, Eligibility, Benefits
- Enrollment Modules
- Eligibilty Lookups
- Benefit tier design, creation, inquiry
- Premium Collection
Referrals, Authorizations
- Automated approval, pend, or deny mechanisms
- Integration with claims
- Online inquiry for physician services
EDI Processing
- EDI 837 Professional Claims submission and processing
- EDI 837 Instituional Claims submission and processing
- EDI 271 Eligibility and Benefit submission and processing
- EDI Object creation and set managment
- 4010/5010 Upgrades
- HL7 Interfaces
Medical Coding and Federal Regulations
- HCPCs
- CPTs
- ICD-9
- ICD-10
- HIPAA Security modules and practices
Providers and Payments
- Complex network implementations
- Fee for Service structures
- Pay for Performance modules
- Managed Care modules
- Physician Search modules
- Seamless integration with Great Plains, QuickBooks
Credentialing
- Automated Application Process
- Automated web-site updates for Physician search modules
- Work-Flow scheduling and tracking
Claims Adjudication
- EDI Transaction based adjudication
- Real-time adjudication
- Referral Integration
- Multiple Surgery processing integration
- National Correct Coding processing and integration
- Claims re-pricing
Data Warehouse and Reporting
- OLAP
- SQL Server Reporting Services (SSRS)
- Business Objects (Crystal Reports)
- Office Automation
- Pivot Table creation
Retail
Sales
- Quotes
- Templates for repeat orders
- Point of Sale
- Sales with Delivery and Installation
- Seamless integration into accounting modules
Delivery, Installation, and Service
- Integrated Warranty Rules
- Parts and Service Sales
- Schedule and Routing Modules
EDI Processing
- EDI 850 Processing of Purchase Orders
- EDI Receiving
Customer Profile and integration with Sales
- Tracking key interactions and customer information
- Targeting customer needs and demands
- Integration of sales and invoicing to ease customer management
- Integration with customer (business) web sites and architecture
Inventory
- Barcoding and tracking
- Pricing and Costing
- Historical Tracking
- Just-in-Time modules
- Physcial Inventory and Cycle Count modules
- Vendor Returns
Puchasing and Receiving
- Stock level Purchases
- Consolidated sales and schedules with sales history purchases
- Cross docking and Just-in-Time purchases
- Manufacturing lead atimes and furture delivery purchases
- Multiple receviers per PO shipment processing
Data Warehouse and Reporting
- EDI Transaction based adjudication
- Real-time adjudication
- Referral Integration
- Multiple Surgery processing integration
- National Correct Coding processing and integration
- Claims re-pricing
Data Warehouse and Reporting
- OLAP
- SQL Server Reporting Services (SSRS)
- Business Objects (Crystal Reports)
- Office Automation
- Pivot Table creation
- Integration with Microsoft Exchange and Outlook
Electronic Commerce
- Integration with existing internal systems
- Integration with existing accounting systems
- Adopting best-in-class modules to existing environment