The Claims Management System facilitates raw data import & export to trading partners via IGI's Health B2B translator module. It comes ready with data entry screens for the HCFA 1500 UB92 forms and MC12, an accounts receivable module and an extensive reporting module.

The system functionality is given below:

• Multiple trading partners can send/receive their claims in any given format (including print image).
• This system will validate the file and user, scrub the data, process payer or plan specific edits, translate the data and load it into a staging Data Mart.
• From the Data Mart, information is edited for required fields; dates are validated and relational fields and values are processed. The industry standard fields are compared for value against master tables. Claims that do not meet the required criteria are marked for Rejections.
• All accepted claims are loaded into the Payer Adjudication system for processing.
• The Claims Management module also processes: claim status, electronic remittance advice, electronic funds transfer and explanation of benefits as this information is downloaded from the Payer Adjudication and loaded into the Data Mart.
• Through a web based front end or email, trading partners, providers and members can query, download or receive these transactions.
  
  
  For more information or to request a demo of Claims Management, email to info@igihealth.com or call 732.271.0600 x1513.