| WinPIMS | Accounting | Insurance | Clinical | Reporting | Administrative |
The Insurance software modules provide excellent tools to assist in the management and maintenance of treatment processes involving managed care including contract management and insurance claims processing tools.
Insurance Administration
The Insurance Administration software provides staff the ability to view insurance claims that have been submitted to insurance companies. By utilizing this software, staff can view and inquire about charges applied to the episode, claim submission data for each episode, the date the claims were filed, insurance company information, current status of that claim and other pertinent information and/or comments on what was deemed patient responsibility.
CRuD
The Contract Resource Directory (CRuD) provides a detailed listing of each insurance/managed care, employer agreement or contract between the organization and third party payers for the purpose of billing and claims reimbursement. CRuD software allows user to access contract details including rate information, required CPT-4 or REV codes, special billing instructions, particular account protocols for the purpose of managing the specific needs/requirements of the contract, i.e., EAP reporting requirements, contact names/addresses, contract effective dates, and facilities included within specified contract.
Insurance Benefits
The Benefits application allows users to access detailed information regarding patient insurance coverage. It provides organizations with insurance company requirements as well as deductibles, co-pays, contract data, levels of care, stipulations regarding the insurance policy and claim submission information including where to submit the insurance claim upon patient's discharge.
