- Offers electronic data interfaces enabling providers to transmit and receive electronic data to/from health plans.
- Supports institutional, physician, pharmacy, dental, and proprietary data formats.
- Applies value-added claims editing and business rules logic, translation and routing, to deliver electronic transactions in industry standard and proprietary formats.
- Manages Provider on-boarding, registration, payer approvals, and the business rules engine helps manage provider ID cross map for accurate file submissions.
- World Class Customer Service Center assists providers with claim rejections, training, forgotten password and other transaction related questions.
- Handles all HIPAA transactions including: Claim (837), Claim Status (276/277), ERA (835), Eligibility (270/271), Referral/PreAuth (278), Patient Information (275), etc.(275).
Key Components Include:
Claims:
Orbit® utilizes Batch or Direct Data Entry (DDE) features that are easy to use, access, and comprehend. The DDE forms resemble actual physician, hospital, and dental bills and are universally accessible at any time. There are many other features including: preloaded codes and drop down boxes and there is also built-in Eligibility Member verification.
Claims Manager
The Orbit® Claims Manager offers complete control over Electronic Claims Submission, and offers salient features such as the "holding, deleting, replacing, voiding, and resubmission" of claims, for various circumstances. Copying claims is another key feature that allows Providers to pull up a "Copy" of an already submitted claim, Edit the required fields, and submit it electronically. This will greatly reduce the time to complete claims, for high-frequency patients and procedures.
ORBITŪ Batch Claims
ORBIT® Batch Claims has the ability to electronically transmit 837 and non-837 formatted batch files for large and small volume claim submitters and allows for the batch submission of multiple Providers, all from one Account Log-In. Once batch claims are imported, then each claim can be individually managed, edited, deleted, held or released by the user.
ORBITŪ Secondary/Tertiary Claims:
Providers can submit Electronic Secondary and Tertiary Claims via ORBIT® to any of the Contracted Payers. Secondary and Tertiary Claims from already submitted Primary and Secondary Claims can be produced through ORBIT®, with all of the required details mapped from the prior Claim.
ORBIT® Claim Attachment
ORBIT® Claim Attachment facilitates the upload of electronic attachments and documents that are required to be filed along with a claim.
Claims status inquiry and Claims Status:
Providers are able to view the status of claims that have been transmitted right in ORBIT®. Statuses can be requested on demand or are automatically returned from payers in the form of a report. Statuses include any notification, rejection or denial. Any claim status report or response can be exported into MS Excel for internal purposes.
Eligibility and Member Benefits:
Providers can execute Real-Time or Batch Eligibility requests via ORBIT®. Requests can be sent for patients and dependents and includes results from over 500 Contracted health plans. Responses detail patient's coverage, deductibles and co-payment rates.
Electronic Remittance Advices:
ORBIT® parses payment information received from the health plans into a human readable report format that is presented to the user in the same view, regardless of which health plan returned the payment information. Additionally, the remittance advice details can be delivered in raw 835 files, which can be used to post directly into the office practice management or EMR system.
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