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What is ppoONE Connect?

This application simplifies the task of modifying claims pricing through an online platform. WebCR not only verifies the involvement of healthcare providers and patient eligibility but also assesses the authenticity of service dates while identifying possible duplicate claims. Supported by a committed data management team and system known as WebDM, it ensures the precision and relevance of data. Furthermore, it includes advanced features designed to enhance user satisfaction and boost operational productivity. Overall, this software represents a significant advancement in claims processing efficiency.

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

API Availability

Pricing Information

$1000.00/month

Pricing Information

Pricing not provided

Supported Platforms

SaaS

Supported Platforms

SaaS

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
Web-Based Support

Training Options

Not specified

Training Options

Not specified

Company Facts

Organization Name

ppoONE

Date Founded

1996

Company Location

United States

Company Website

www.ppoone.com

Company Facts

Organization Name

Complete Health Systems

Company Website

completehealthsys.com/claims/

Categories and Features

Claims Processing

Claim Resolution Tracking
Customer Management
Electronic Claims
Paper-Based Claims

Categories and Features

Claims Processing

Not specified

Health Insurance

Not specified

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