EnCore automated Claims Management solutions provide a higher level of productivity and accuracy. Tightly integrated EnCore applications and specialized third-party plug-in solutions work together to process your hospital, medical, dental, vision and pharmacy claims efficiently in complete compliance with HIPAA mandates.

 

EnCore Offers:

• Unique Benefit Plan Design Capabilities

• Rapid Data Entry

• Batch Adjudication

• Unique COB Calculation & Features

• Electronic Data Interchange [EDI]

• Subrogation tracking

• Currency conversion

• Fully automated benefit calculations with parameter driven design

• Comprehensive customer service event tracking

• Full Provider information management

• Automated claim audit selection

• Duplicate checking

• Automatic letter generation

• Easy adjustment processing with full audit trail

• Fund accounting. tracking and reporting

• Reinsurance tracking and reporting

• Tooth chart and dental history by tooth

• Dental wait period capability

• Pre-treatment estimates for dental services

• Integrated claims routing via user-configured workflow

• ...Just to mention a few

• Clinical editing and unbundling edits

• Usual and Customary fee schedules

• HealthX Fax/Net Recall Products

• Multi-level help resources

• Unlimited notepad capabilities

• Sophisticated name search functionality

• Ad Hoc reporting