WorkFlow Management

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Solutions Integrated To Technology

Trak-it Front end

 

 

GlobalCare advances claims processing with technology-based solutions that integrate to our client systems and processes.

 

 

 

 It Begins With Every Claim

GlobalCare offers comprehensive front-end claims processing to facilitate electronic claim transport along selected pathways. We offer clearinghouse-type services where claims can be received from any source, and converted to a standard file layout acceptable by all trading partners. All claims undergo stringent edits to normalize data for ready acceptance to elevate our client’s auto-adjudication rates. We recognize that the fewer manual interventions, the greater the impact to the bottom-line.

THE VALUE TO YOU

  • No system or process changes
  • We conform to your file layouts and preferences
  • No financial outlays: no fees for file set-up or monthly maintenance

GlobalCare provides web-based tools to easily allow complete monitoring for all files and claims activity. Real-time tracking of all data inbound/outbound traffic by trading partner is date/time recorded with details provided inclusive of image records (if available). Our Online Services and Trak-IT systems allow easy access to your data with total transparency.

Online Services demo>          Trak-IT demo>         

Put Our Savings Technology Solutions To Work For You

 

Services Available

PAPER MANAGEMENT

  • Claim receipt from providers & any trading partner
  • Claim scanning and data entry
  • Claim archiving
  • Claim inventory control
  • Claim image retrieval

COORDINATION / EDI MANAGEMENT

  • Claims from providers, networks and clearinghouses
  • Claim conversion to standard ANSI 837I/4010 & ANSI 837P/4010
  • Claim conversion from / to any proprietary file format
  • Claim transmission via secured and encrypted hosted ftp site
  • Claim transmission via secured and encrypted web-portal with 837 batch files
  • Claim transmission via secured web-portal with print-on-demand reproduction HCFA1500 OR
  • UB92 with re-pricing results
  • HIPAA Compliant

CLAIMS RE-PRICING MANAGEMENT

  • Primary network re-pricing (Inanet Primary)
  • Primary network routing (MedRouter)
  • Secondary network re-pricing (Inanet)
  • Re-pricing via PPO Networks, Fee Negotiators and Arbitration Services
  • HIPAA Compliant

NETWORK MANAGEMENT

  • PPO contracting with over 150 PPOs and growing
  • PPO contracting for primary access and secondary access
  • PPO provider demographic loads
  • 837 File conversion to network specifications
  • PPO matching rules
  • HIPAA Compliant

AUTO-CLAIM EXTRACTION & REINTRODUCTION

  • Technology-based solutions that integrate with selected claims adjudication systems
    • Automated file extract (primary / secondary claim files)
    • Automated reintroduction

ON-LINE TRACKING & REPORTING

  • Web-based claim inquiry, claim inventory, and performance-based reporting
  • Claim monitoring: over 30 points of tracking a claim life
  • Claim record & Claim image retrieval and archiving

e-INVOICING WITH AUTO REVERSAL & RECONCILIATION

  • Secondary claim invoices with GlobalCare fees passed within ANSI837/4010 file
  • Automated reversal & reconciliation for non-use of secondary discount as reported by client