The
FACTS® family of products supports multiple lines of business
within a single information system: Health, Indemnity, TPA,
PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, Section
125-Integrated Flexible Benefits, and Workers' Compensation
with Integrated Managed Care for 24-hour coverage.
Expert management of all
key components of your business
- Claim and encounter processing
- Managed care administration
- Workers' compensation administration
- Policy/Benefit administration with support for eligibility,
billing, collections and commissions
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HIPAA Compliance
From the inception of HIPAA, the FACTS® system infrastructure
has been based on HIPAA-compliant solutions. FACTS® is fully
committed to ensuring a clear and easy path to HIPAA readiness
- well ahead of the federally mandated compliance deadlines.
Interactive "Web"
and "Voice-Enabled" Benefits Communication
FACTS® fully integrated, interactive Internet and voice-based
systems empower healthcare administrators and professionals
with 24 x 7 access to claims and benefit information, and real-time
transactions such as EDI claim uploads, through the Internet.
Fully integrated, advanced technologies
for added functionality and advanced productivity
- Automatic claim adjudication
- Electronic Data Interchange (EDI)
- Electronic claim workflow
- Claim processing/pre-processing
- Automatic claim coding
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- Optical imaging / IOCR
- MICR laser check / EOB encoding
- Standard/custom report generation
- Letter generation
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Managed Care
- Clinical editing and auditing
- Provider network management
- Provider capitation management
- Pre-Authorization, UR, UM,
and physician referrals
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- Point of Service (POS)
- Primary Care Physician profiling and credentialing
- Case management
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United
States 
