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Description

Authorize, claim processing and payment are available at the point-of-care. Improve care coordination and improve outcomes for lower medical costs while streamlining administrative processes. Engage providers at point of care to share and capture data in real time, resulting in an unprecedented exchange of health information. We work with our clients to develop risk management strategies that produce better outcomes at lower costs. We aim to improve the user experience of everyone in the ecosystem. To optimize clients' resources, we deliver a minimum of a 3:1 ROI. Conexia has created a core technology platform (ONE), which can be customized to meet the different regulatory requirements and operational processes of each client in each geographic region. Our initial implementation is usually an overlay on the existing technology ecosystem of the payer to create real-time processes.

Description

I-CAPS stands for Intelligent Claims Administration System, designed to comprehensively cover all aspects of the health claims payment sector through a unified architecture that meets the diverse requirements of payers, including areas such as membership management, billing, enrollment, mailroom operations, claims processing, network oversight, contracting, pricing strategies, utilization reviews, and customer support. Our I-CAPS, along with our Advanced Value Scale (AVS) coding compliance software, facilitates informed decision-making to assist clients in managing expenses effectively. The Advanced Network Administrator (ANA) ensures the accuracy of provider information in an efficient manner, while our Resource-Based, Usual Customary, and RESPONSIBLE fee schedule (RB-UCR) is a pioneering solution in the market, built on RBRVS and NCCI frameworks. For a thorough assessment of your plan or provider’s performance, consider utilizing our Cost Containment Audit and Recovery Services (CCARS), which provide a meticulous and non-intrusive evaluation of claims efficiency. This holistic approach not only enhances operational effectiveness but also promotes greater transparency within the health claims ecosystem.

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

Customer Support

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

Customer Support

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

Types of Training

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

Types of Training

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

Vendor Details

Company Name

Conexia

Founded

1996

Country

United States

Website

conexia.com/en

Vendor Details

Company Name

W.O. Comstock & Associates

Website

www.amrhealth.com

Product Features

Benefits Administration

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

Claims Processing

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

Healthcare CRM

Audience Targeting No 
Campaign Management Yes 
Marketing Automation No 
Medical History Records Yes 
Patient Communications No 
Patient Management Yes 
Physician Management Yes 
Predictive Analytics Yes 

Hospital Management

Accounting Integration No 
Appointment Management No 
Appointment Scheduling No 
Bed Management No 
Billing & Invoicing No 
Claims Management Yes 
In-Patient Management No 
Inventory Management No 
Medical Billing Yes 
Out-Patient Management No 
Patient Records Management No 
Physician Management No 
Policy Management Yes 
Revenue Management No 

Medical Billing

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

Population Health Management (PHM)

Analytics Yes 
Cost-of-Care Analysis Yes 
Data Storage No 
EMR/EHR Integration No 
Patient Engagement Yes 
Patient Identification Yes 
Patient Risk Stratification Yes 
Patient-Reported Outcomes Yes 
Payment Bundling Yes 
Predictive Alerts Yes 
Test & Treatment Reminders Yes 
Utilization Tracking Yes 

Product Features

Claims Processing

Adjustor Management No 
Case Management No 
Claim Resolution Tracking Yes 
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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