MedinClaim provides a comprehensive set of functionality that enables accurate, automated, end-to-end claim processing. The unique MedinClaim architecture is a generation ahead of its closest competitors.
- Single solution to address all aspe
cts of medical claim processing in one integrated system: plan definition, provider agreements, claim management, bill auditing, managed care and hospitalization review, and more. - Centralized management of all interactions between payers, providers, and the insured.
- Strict data-entry validation.
- Centralized database for clean and consistent data for processing.
- Complete automation for high throughput and reduction in processing costs.
- Fraud and overbilling detection for reduced payouts.
- Total transparency and real-time access to every process and data item.
- High customizability to fit any environment, local regulation, plan, agreement, policy, administrative regime, clinical guidelines, etc.
- Dual nomenclature: international coding and natural language.
- Efficient image indexing.
- Single data entry for all processes and applications and direct access to all modules from all other modules.
- Absolute security based on strict authorization rules.
- Full connectivity and interfaces to legacy systems and external organizations (supplirs).
MedinClaim offers multiple and advanced coordinated components that provide a 360⁰ view of each insured, improving efficiency and productivity:
- Insurance plan definitions
- Policy data
- Provider agreements administration
- Medical guide-line definitions
- Claim adjudication
- Referral and pre-authorization management
- Bill repricing, review or auditing
- Computerized medical records (EMR)
- Medical review
- Managed care and hospitalization monitoring
- Image archive with automatic indexing
- Paper less processing
- CRM
- Correspondence
- Payment orders (bank transfers and check printing)
