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Ratings and Reviews 0 Ratings
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What is Newgen Claims Processing?
Optimize the entire claims process by automating every stage, from the initial loss notification and fraud detection to adjudication and final settlement. This system allows for the distinct handling of various claim types, such as death and maturity claims, while ensuring strict compliance with regulations to avoid any penalties. You will experience enhanced efficiency and accuracy in processing through features that manage data collection, oversee payments, handle salvage and recovery, process legal cases, and offer thorough monitoring. Additionally, the effective registration, adjudication, tracking, and oversight of all claim submissions are ensured. The integrated business rules facilitate automatic categorization of claims into “fast track” or “non-fast track” groups. Furthermore, you can effortlessly add or modify stakeholders involved in the claims process—such as garages, assessors, loss adjusters, surveyors, investigators, and claims officers—to boost operational efficiency. This all-encompassing strategy not only streamlines workflows but also promotes collaboration among all participants in the claims process. Finally, by implementing these enhancements, organizations can significantly improve their overall claims management experience.
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.
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
Newgen Software
Date Founded
1992
Company Location
India
Company Website
newgensoft.com/solutions/industries/insurance/claims-processing/
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