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Average Ratings 0 Ratings

Total
ease
features
design
support

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Write a Review

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 

Screenshots View All

Screenshots View All

Integrations

Gradelink SIS Yes 

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 

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