H.M.O. Managed Care
Managed Care Capabilities
The managed care module tracks the capitation payment against the charges incurred during the specific period. It also automatically takes the required contractual adjustment for that period.
H.M.O. Analysis
The anticipated pay analysis processes incorporated into the REXPERT System, identifies the financial and statistical data by payor. Information regarding various payors can be related to each other in report form, so you can determine the impact of
dealing with one payor as compared to other payors.
Payment Eligibility
The insurance status and eligibility of a patient can be verified electronically through the REXPERT System, to many major insurance carriers. This allows your staff to avoid wasted time and effort expended upon erroneous billing.
Payor Notes “Pop Up” Feature
The REXPERT System allows reminders specific to a payor to “Pop Up” as needed throughout the registration and charge entry process. These notes can alert your staff about collecting specific co-pays, or utilizing certain institutions for procedures or tests.