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Average Ratings 0 Ratings

Total
ease
features
design
support

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Write a Review

Description

BRMS excels in the efficient and precise processing of all Medical, Dental, Vision, and Retiree claims, ensuring a swift turnaround time. We seamlessly update eligibility each night through our MyHealthBenefits system, maintaining up-to-date information. Our expertise in PPO negotiations allows us to effectively lower costs for employers regarding claims. We oversee the full spectrum of claims administration, from initial receipt and eligibility verification to negotiation and final payment. By centralizing all operations in-house, including claims processing, medical management, PPO network oversight, and billing, we offer a responsive and personalized service experience. For self-insured entities, BRMS serves as an invaluable partner in handling Medical, Dental, and Vision claims with exceptional accuracy and efficiency. Our commitment to quality and customer satisfaction sets us apart in the industry.

Description

Claims adjudication services cover a range of areas including medical, dental, vision, and prescription claims, as well as short and long-term disability cases. These services can be accessed either on-site with a license or through a hosted application model (ASP). Utilizing Microsoft technology, the system is powered by an SQLServer database paired with a Windows front end. Our customer service is highly regarded, staffed by healthcare claims professionals who boast a minimum of 12 years of industry experience. All support inquiries are recorded, and their statuses can be monitored online. The system features a plan copy and modification tool that facilitates rapid plan implementation. Auto-adjudication is achieved through benefit codes that are constructed using business rules derived from over 25 variables connected to both the claims and the claimants, which are then processed by the adjudication engine. Claims can be submitted in various formats, including scanned images, EDI, or paper submissions. The system is compliant with HIPAA EDI 5010 transaction sets, ensuring secure and efficient processing. Additionally, re-pricing fees and UCR schedules can be pre-loaded into the system prior to their effective dates, while the date-driven logic ensures that re-pricing occurs based on the service date, optimizing the claims processing workflow. The comprehensive nature of this system allows for a more streamlined and efficient claims management experience.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial No 
Free Version Yes 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App Yes 
iPad App Yes 
Android App Yes 
Windows Yes 
Mac Yes 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs Yes 
Webinars Yes 
Live Training (Online) Yes 
In Person Yes 

Types of Training

Training Docs No 
Webinars No 
Live Training (Online) No 
In Person No 

Vendor Details

Company Name

Benefit and Risk Management Services

Founded

1993

Country

United States

Website

www.brmsonline.com

Vendor Details

Company Name

Complete Health Systems

Website

completehealthsys.com/claims/

Product Features

Benefits Administration

COBRA Administration Yes 
Claims Management Yes 
Deduction Management Yes 
Disability Insurance Administration Yes 
Employee Benefits Administration Yes 
FMLA Administration Yes 
FSA Administration Yes 
Flexible Spending Accounts No 
For Brokers Yes 
For Employers Yes 
HIPAA Compliant Yes 
Health Insurance Administration Yes 
Life Insurance Administration Yes 
Online Benefits Enrollment Yes 
Premium Billing No 
Provider Management Yes 
Retiree Administration Yes 
Retirement Plan Management No 

Product Features

Claims Processing

Adjustor Management No 
Case Management No 
Claim Resolution Tracking No 
Co-Pay & Deductible Tracking No 
Compliance Management No 
Customer Management No 
Electronic Claims No 
Forms Management No 
Paper-Based Claims No 
Payor Management No 
Policy Administration No 

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