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Average Ratings 0 Ratings

Total
ease
features
design
support

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Write a Review

Description

EMCsoft's Claims Management Ecosystem guarantees that healthcare providers and billing companies submit accurate claims to insurance payers for effective claim processing. This system combines our adaptable claims processing software, Claim Agent, with a comprehensive methodology known as the Four Step Methodology, seamlessly integrating into your claim adjudication workflow. By implementing this strategy, we enhance, facilitate, and automate your processes to optimize claim reimbursements. For an insightful overview of Claim Agent's features and its integration into your claims process, you can request our complimentary online demonstration. Claim Agent efficiently manages the scrubbing and processing of claims, ensuring a smooth transition from provider systems to insurance payers in a timely and cost-effective manner. The software is designed to be compatible with any existing system, ensuring a swift and straightforward implementation. Furthermore, we offer tailored edits, bridge routines, payer lists, and workflow configurations that cater specifically to each user's requirements, enhancing the overall claims management experience. This personalized approach enables healthcare providers to focus more on patient care while we take care of the complexities of claims processing.

Description

Streamline the complete claims process by automating steps from the initial loss notification and fraud detection through to adjudication and final settlement. Enjoy the capability to handle various claim types distinctively, such as death claims and maturity claims, while enhancing adherence to regulations and avoiding penalties for non-compliance. Achieve more efficient and precise processing with features for data collection, payment oversight, salvage and recovery management, legal case processing, and comprehensive monitoring. Ensure effective registration, adjudication, tracking, and oversight of all claim submissions. Utilize integrated and detailed business rules that enable claims to be categorized automatically into “fast track” or “non-fast track” categories. Additionally, you have the option to easily add or adjust stakeholders involved in the process, including garages, assessors, loss adjusters, surveyors, investigators, and claims officers, to further enhance operational efficiency. This comprehensive approach not only simplifies workflows but also fosters collaboration among all parties involved in the claims journey.

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 No 

Pricing Details

No price information available.
Free Trial No 
Free Version 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 

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 Yes 

Customer Support

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

Types of Training

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

Types of Training

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

Vendor Details

Company Name

EMCsoft

Founded

1980

Country

United States

Website

emcsoft.com

Vendor Details

Company Name

Newgen Software

Founded

1992

Country

India

Website

newgensoft.com/solutions/industries/insurance/claims-processing/

Product Features

Long Term Care

Claims Management Yes 
Clinical Care No 
EHR No 
Electronic Health Record No 
For Home Care Providers No 
For Nursing Homes No 
Geriatric Care No 
MDS Review No 
Patient Records No 
Staff Scheduling No 

Medical Billing

Claims Processing No 
Claims Scrubbing Yes 
Code & Charge Entry No 
Compliance Tracking Yes 
Customizable Dashboard Yes 
Dunning Management Yes 
Invoice History Yes 
Patient Eligibility Checks No 
Practice Management No 
Quotes/Estimates Yes 
Remittance Advice 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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