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What is CyberSource Medical?

Presenting an unparalleled and precise option in the realm of claims management, the CyberSource Medical Claims Scanning Solution stands out as a comprehensive system tailored for HMO, PPO, TPA, or Self-Funded Organizations. Installed directly at your facility, it automates data entry for a range of forms, including CMS-1500, ADA-2006, UB-04, and enrollment documents. Utilizing advanced "intelligent" features alongside your specific operational protocols, CyberSource effectively identifies, verifies, and formats data derived from medical claim submissions. Its innovative Fuzzy Matching technology skillfully navigates your member and provider databases to guarantee precise identification of data matches. After matching, the verified data is instrumental in confirming and correcting any discrepancies on the medical claim before it progresses to the adjudication phase. The integration of superior OCR capabilities, customized business guidelines, and robust Fuzzy Matching results in remarkable accuracy in the processing of data from your medical claims forms, ultimately boosting operational efficiency. With this cutting-edge solution, organizations can drastically reduce errors and optimize their claims processing workflows, leading to improved overall performance and reliability in claims management.

What is Complete Claims?

Claims adjudication services encompass a variety of sectors such as medical, dental, vision, and prescription claims, along with both short and long-term disability cases. These services can be accessed on-site with a license or through a hosted application model (ASP). Powered by Microsoft technology, the system employs an SQLServer database and a Windows front end for optimal performance. Our customer service team is highly esteemed, comprised of healthcare claims experts with at least 12 years of experience in the industry. Every support request is documented, allowing clients to track their status online. The system includes a plan copy and modification feature that enables quick implementation of changes. Auto-adjudication is facilitated through benefit codes built on business rules that take into account over 25 variables related to both claims and claimants, all processed by the adjudication engine. Submissions can be made in various formats, including scanned images, EDI, or traditional paper submissions. The system adheres to HIPAA EDI 5010 transaction sets, guaranteeing secure and efficient processing. Furthermore, re-pricing fees and UCR schedules can be entered into the system ahead of their effective dates, while the date-driven logic ensures re-pricing is executed based on the service date, enhancing the overall workflow of claims processing. This comprehensive solution not only streamlines claims management but also significantly improves client satisfaction and operational efficiency.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

ComCom Systems

Company Website

www.comcomsystems.com/solutions/cybersourcemedical

Company Facts

Organization Name

Complete Health Systems

Company Website

completehealthsys.com/claims/

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

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