eMids Technologies Blog

GreenClaim

With a view to enhancing our solution offering, eMids is proud to offer product based solutions through its GreenClaim suite. eMids continues to seek value for its clients and in the near future would have more additions to its solution sets. The following are the products under the GreenClaim suite:

• GreenClaim – health mason
• GreenClaim – TheSys

GreenClaim – health mason
GreenClaim – health mason is a multi utility scripting tool modeled on the usage of artificial intelligence.

Claim backlogs cost health plans millions of dollars a year in staffing, settlements, penalties, overpayments, and legal fees. For those organizations that can afford it, the only recourse is to add temporary staff or to contract with outsourcing vendors. Beyond cost, these solutions introduce human input errors and increase interpretation variance from one claim adjuster to the next. Moreover, neither solution is capable of clearing a large claim backlog in a very short amount of time.

GreenClaim – health mason is a product that connects to any claim system over a secure connection – in exactly the same manner as existing outsourcing solutions. GreenClaim – health mason can process tens of thousands of claims in a matter of days and do so with unparalleled quality and accuracy. Once a backlog is cleared, GreenClaim – health mason can be used on an ongoing basis to handle spikes in volume or simply to augment capacity.

GreenClaim – TheSys
GreenClaim – TheSys maximizes ROI through automation; this includes real-time adjudication, point of service adjudication, EDI, security, high configurability, and reliability.

GreenClaim – TheSys has transformed from a simple health plan system to one of the most flexible rules based adjudication systems on the market. GreenClaim – TheSys was originally designed to serve the complex payment structures of PPO systems; GreenClaim – TheSys is one of the most configurable systems on the market that can handle myriad benefit plans, fee schedules and lines of business. Any changes to adjudication are handled by configuration settings that are client controlled, resulting in an adjudication that requires little to no custom development.

GreenClaim – TheSys also provides Point Of Service Claims Adjudication, real-time referral, real-time authorization, and eligibility checks for providers. These automated features have reduced excesses in staffing by providing direct contact to providers.