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What is I-CAPS?

I-CAPS, which stands for Intelligent Claims Administration System, is a comprehensive solution tailored to address all elements of the health claims payment landscape through a cohesive structure that caters to the varied needs of payers. This includes essential functionalities such as membership management, billing, enrollment, mailroom operations, claims processing, network oversight, contracting, pricing strategies, utilization reviews, and customer support. Our I-CAPS system, combined with the Advanced Value Scale (AVS) coding compliance software, empowers clients to make well-informed decisions, aiding them in effectively managing costs. Additionally, the Advanced Network Administrator (ANA) streamlines the accuracy of provider information with high efficiency. Our innovative Resource-Based, Usual Customary, and RESPONSIBLE fee schedule (RB-UCR), grounded in RBRVS and NCCI frameworks, stands out as a market leader. To thoroughly evaluate your plan or provider’s performance, we recommend our Cost Containment Audit and Recovery Services (CCARS), which deliver a careful and non-disruptive analysis of claims efficiency. This comprehensive strategy not only boosts operational performance but also fosters increased transparency in the health claims sector, ultimately benefiting all stakeholders involved. By implementing our solutions, organizations can significantly improve their overall claims management processes while enhancing service delivery.

What is Ebix FACTS?

The FACTS® product suite serves a diverse range of industries through a cohesive information system that encompasses Health, Indemnity, TPA, PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, Section 125-Integrated Flexible Benefits, and Workers' Compensation with Integrated Managed Care, providing comprehensive coverage around the clock. Since the introduction of HIPAA, the foundational design of the FACTS® system has focused on solutions that comply with HIPAA regulations. With a strong commitment to making the path to HIPAA compliance as smooth and efficient as possible, FACTS® emphasizes preparation well ahead of mandated federal deadlines. The fully integrated and interactive systems offered by FACTS®—which can be accessed through both the Internet and voice—empower healthcare professionals and administrators with 24/7 access to critical claims and benefit information, while also facilitating real-time transactions such as online EDI claim submissions. By leveraging these resources, organizations can greatly improve their risk management and insurance oversight processes. In addition, FACTS® is unwavering in its commitment to ongoing enhancement of its services to better meet the evolving needs of its users, ensuring that they are always equipped with the best tools available. This dedication to improvement underscores the company's mission to provide exceptional support tailored to the challenges faced by its clientele.

Media

Media

Integrations Supported

Integrations Supported

Gradelink SIS

API Availability

API Availability

Pricing Information

Pricing not provided

Pricing Information

$25000 one-time payment

Supported Platforms

Windows

Supported Platforms

Windows
Linux

Customer Service / Support

Web-Based Support

Customer Service / Support

24 Hour Support
Web-Based Support

Training Options

Documentation Hub
On-Site Training

Training Options

Documentation Hub
On-Site Training

Company Facts

Organization Name

W.O. Comstock & Associates

Company Website

www.amrhealth.com

Company Facts

Organization Name

Ebix

Date Founded

1989

Company Location

United States

Company Website

www.ebix.com/facts

Categories and Features

Claims Processing

Claim Resolution Tracking

Network Management

Not specified

Categories and Features

Claims Processing

Adjustor 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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