QLAdmin Medicare Supplement Claims Auto-Adjudication
QLAdmin Medicare Supplement insurance claims auto-adjudication is deployment ready with integration to third-party clearinghouses. All plans in all 50 states are supported for both Part A and Part B. Processing between 300 to 500 claims per minute, the adjudication engine runs 24/7 and continues to parse and queue incoming EDI files. Bring your business back in-house or get into this growing market.
- Claims processing dashboard with real time and historical adjudication data.
- Business rules engine for benefit processing parameters for all plans in all states.
- Automatic duplicate and eligibility checks.
- Manual claims queue for exception processing and settlement.
- Rate increase management for state filings, approvals, documentation, and implementation.
- New business import utility for incoming Acord XML files.
- Policy level history with before and after rate increase details and documents.
- Set processing rules and adjudication parameters without the need for programming or IT expertise.
- Greatly reduce manual claims processing and increase efficiency and accuracy.
- Increase timeliness and accuracy for implementing rate increases.