The New Generation Core Claims Administration Processing System
We provide an affordable Enterprise Core Claims Administration Processing System for the Healthcare Payer Market
Business Transformation Made Easier
Legacy core claims administration processing systems no longer provide the efficiencies, flexibility, integration abilities, and automation needed for healthcare payers to keep pace with industry demands and the digital transformation that will continue for many years to come.
Healthcare payers must move to modern technology to continue to advance operations and control costs while meeting the ever-evolving requirements and improvements their clients, members, providers, and the industry need.
Developed By Healthcare Payer Professionals
Lower operational costs from fast user adoption. No technical language to get in the way.
Built to Install
Designed from the ground up to take less time to go-live and enhance your business opportunities.
Built to perform
Architected to be able to handle millions of transactions to support your business needs.
Architectural Advantage
Built using the latest technology.
Flexible Product Licensing
Licensing structures designed to meet the needs of your organization.
One Complete System
A business cornerstone that you can rely on to perform.
The new generation of intellicare stands ready to respond to the revolution in healthcare systems and technologies with a new generation of an affordable enterprise core claims administration processing system for the healthcare payer market.
The legacy of intellicare began eight (8) years ago with new ideas, creative designs, and technology innovation to address the gaps in today’s healthcare payer systems.
The intellicare new generation software platform was built on a strong foundation of forward directed healthcare technology and payer experience. The system has been built from the ground up by experienced healthcare payer users and executives that have worked with many different core claims systems and different lines of business.
The intellicare product provides the ability to deliver quality data, integrated processes, and fluid interaction between plans, providers, and members by using modern proven technology.
This new generation of solution operates on one integrated platform. The user interface provides for quick and easy access to information and provides for deep functionality to support information processing and sharing across the healthcare continuum. Rules based indicators and triggers allow for proactive and retrospective automated actions across the system to support, clinical, financial, and operational actions.
Product Features
Workflow Management
Member Management
Enrollment
Groups
Sub Groups
Confidentiality
ID Cards
EOBS
Benefit Management
Building Block Approach
Build and Reuse
User Defined Accumulator Hierarchy
Flexible Claims Rules
Cascading Benefits
Provider Management
Providers - Networks
Fee schedules – Cap schedules
Contracts – Business Segment
Provider Balance Payment
Credentialing
Fee Schedules
Capitation
Provider Balances
Hospital Management
Check Runs
EOPs
Medical Management
Case
Referral and Authorization
Assessments, Problems, Intervention, Care Plans
Claims Management
Customizable Processing Rules
Medical, Hospital, Dental, Pharmacy
COB, DOFR, Repricing
Claims Cascading
Adjustments, Voids, History
Mass Adjustment
Global Fee Schedules
Cascading Fee Schedules
On Demand or Batch
Attachments, Notes, Reminders
Document Attachments
Customer Service
Queues, Departments, Individuals
Subject, Contacts, History
Calendars, Notes and Attachments
User Tools
Customizable Rules
Customizable Screens
Dashboards
Reports
Analytics
Grids With Sort And Filter Functionality
Integrated With Word
Documents Attachments Across the System
Notes and Reminders Across the System
Production
Security
File Import and Exports
Preprocessing of Check Runs
Check Runs
Auto Assign PCPs
EDI - 5010
Letters and Reports
Job Scheduling and Status
Customizable Auto Adjudication Rules
Premium Billing
Invoices
Posting
Adjustments
Voids
For a free demonstration,
Schedule a consultation today.