Achieve New Levels of Operational Efficiency and Transparency
ikaClaims delivers rapid and automated administration of claims for
both group and individual commercial business lines as well as
Medicare and Medicaid products — all in one system.
ikaClaims delivers:
- Agility and flexibility: ikaClaims helps you rapidly and easily
configure highly granular benefit plans and provider contracts. All
system components and business rules can be user-defined, from the
most basic to the most specific level of detail. You can also utilize
ikaClaims’ pre-loaded benefit categories, pre-loaded fee schedules
and standard/system codes to effortlessly incorporate custom benefit
plans and respond quickly to changing market demands. As a result,
health plans can achieve average auto-adjudication rates greater than
90 percent, typically within 3 months of go-live.
- Interoperability: User-friendly Web-based access and integration
with other Web-based applications make it easy to share processes and
information internally as well as externally, facilitating key
business initiatives such as transparency and collaborative care
management.
- HIPAA compliance: ikaClaims accepts and produces all HIPAA-compliant
transaction code sets (834, 270, 271, 278, 837, 276, 277, 835, 820).
In addition, multiple security levels are possible using role- and
rule-based access configurability.
- Accuracy: With exceptionally high auto-adjudication rates, ikaClaims virtually eliminates the need for manual intervention,
resulting in consistent, accurate claims payments.
- Efficiency: With ikaClaims, you can easily manage referrals and
authorizations, as well as take advantage of automated correspondence
and other customer service tools to reduce the time staff need to
spend on routine activities.
ikaClaims allows health plans to grow without adding more staff, as
well as to improve provider relations with greater payment efficiency
and transparency.
