Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
The FACTS® suite of products caters to various business sectors through a unified information system, including Health, Indemnity, TPA, PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, Section 125-Integrated Flexible Benefits, and Workers' Compensation with Integrated Managed Care, ensuring comprehensive 24-hour coverage. Since the establishment of HIPAA, the architecture of the FACTS® system has been rooted in solutions that adhere to HIPAA standards. Committed to facilitating a straightforward and efficient journey toward HIPAA compliance, FACTS® prioritizes readiness well in advance of the required federal deadlines. The fully integrated, interactive systems provided by FACTS®—accessible via the Internet and voice—equip healthcare professionals and administrators with around-the-clock access to vital claims and benefit information, in addition to enabling real-time transactions like EDI claim submissions online. By utilizing these tools, organizations can significantly enhance their risk management and insurance oversight capabilities. Furthermore, FACTS® remains dedicated to continuously improving its offerings to better serve its users.
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
Integrations
Gradelink SIS
No
Pricing Details
$25000 one-time payment
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Deployment
Web-Based
No
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
Yes
Mac
No
Linux
Yes
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
No
Live Rep (24/7)
Yes
Online Support
Yes
Customer Support
Business Hours
No
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
No
In Person
Yes
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
No
In Person
Yes
Vendor Details
Company Name
Ebix
Founded
1989
Country
United States
Website
www.ebix.com/facts
Vendor Details
Company Name
W.O. Comstock & Associates
Website
www.amrhealth.com
Product Features
Claims Processing
Adjustor Management
Yes
Case Management
No
Claim Resolution Tracking
Yes
Co-Pay & Deductible Tracking
Yes
Compliance Management
Yes
Customer Management
Yes
Electronic Claims
Yes
Forms Management
Yes
Paper-Based Claims
Yes
Payor Management
Yes
Policy Administration
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