|
Feature |
Benefits |
| On-Line entry of
Referral Requests |
Allows providers in the
network to go on-line to enter a referral request. Provides lookup on referring provider, requested provider and member. Diagnosis, procedure codes and requested quantity can all be entered. This module streamlines the referral/authorization process in a cost effective and secure manner. |
| Authorization/Referral
Inquiry |
Allows providers in the network to go on-line to lookup an existing authorization by multiple criteria. Check the approval status, number of visits allowed, etc. at the point of service. This module dramatically improves the management of authorizations for both the MCO and specifically the provider’s office. |
| Provider Directory |
Providers can lookup information on
other providers. This easy to use directory displays contract information, specific credentialing data and general demographics on each provider. Smart searches can be performed on city, zip, specialty etc. Searches can be performed for providers who have contracts within a specific member’s health plan. This module clearly increases efficiency within your provider network. |
| Member Inquiry |
Providers can verify eligibility on a specific member. In addition to effective date, this module also provides full benefit detail with co-pay, deductible, and co-insurance data at the member level. General demographic information and PCP assignment can also be viewed.
Provider's can even verify if specific services are covered with a
click of a button. Reduces the risk of providing non-approved or non-eligible services. Provides patient responsibility data at the point of service. |
| Claim Inquiry |
Allows Provider offices in the network to search for existing claims submitted to the MCO. Smart searches are based on multiple criteria such as claim status,
date ranges and renderring provider. Reduces phone calls between the provider and the MCO. Reduces need for provider services staff. |
| HCFA Compliant Security |
We have implemented
security measures as required by HCFA. You, your providers, and
members will be confident in knowing your data is absolutely
secure. |
| User Authentication |
Username and Password
are required to access the system which also limit what data can
and can't be viewed. Each provider will be confident that their
data is secure. |
| Supports standard Web
Browsers |
Works with both Internet
Explorer and Netscape Communicator. |
| On-Line Help |
Comes with an easy to
use on-line help file |
| Integrated Email |
Provider Office Staff
can communicate directly with your staff via email. |
| Remote Implementation |
Can be implemented using
various methodologies depending on your organization's cost,
usage, and network requirements. |
| Alternative Revenue
Source |
If desired you can sell
access to eMCee Connect to your providers without paying any
royalties to us. |
