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Emdeon of Nashville, TN has interfaced their Mailroom Outsourcing product with CAPS/2020. Emdeon uses a data extract module to provide the necessary raw data for processing into mail documents—checks and EOBs. From this raw extract, Emdeon constructs customized document output, consolidates mail to the same addresses, and uses proprietary mailroom technology to eliminate excess labor, sorting and commingling fees. This saves the typical client over $100,000/year. Finally, Emdeon dramatically helps the TPA cut costs associated with hard copy print and mail operations resulting in savings of $250,000 or more per year.
ComCom Systems of Clearwater, FL has developed an imaging system, which will scan documents directly into the CAPS/2020 system. This will dramatically decrease the time spent inputting the mail. Their system will also allow for Internet access to scanned documents.
Extol of Franklin Lakes, NJ uses their EDI Integrator package to pass information electronically into the CAPS/2020 system. Their package allows for the mapping of all ANSI and proprietary information coming in from clients all around the world.
Ingenix of Salt Lake City, UT has various Usual, Customary and Reasonable (UCR) Fee schedules that enable the CAPS/2020 system to automatically reduce payments. They also have authored the Claims Edit System (CES), which prevents inappropriate billing practices, such as unbundling, missed multiple frequency discounts, billing for follow up days, etc. CAPS/2020 will process claims against the CES system sending all errors to an examiner for further review. Claims that are clean can be sent for automatic payment without any further human intervention.
MAPSYS of Columbus, OH is the IBM hardware and software integrator for CAPS/2020 customers. The IBM iSeries computer is a MAPSYS specialty. They have a team of certified professional specialists providing help with cost justification, solution planning, application development, implementation services, training, support and financing.
SIEBA, Ltd., of Endicott, NY uses their Laser/2020 product to produce all in-house checks and EOBs for the CAPS/2020 system.
Evolution Benefits,Inc. is the industry leader in electronic benefit payment solutions for the employee benefits market. Its primary product, the Benny™ Prepaid Benefits Card, applies advanced payment and patented auto-substantiation technologies to health-related benefits accounts such as Flexible Spending Accounts, Health Reimbursement Arrangements, and Health Savings Accounts. Evolution Benefits’ auto-substantiation technologies were patented in 2007 and other patents are pending. The company now powers the programs of more than 225 administrative services organizations and covers more than 14,000 employers, including over 130 of the nation’s top-ranked Fortune and Forbes companies.
The CAPS/2020 Technical Support Center in Denver, CO, provides telephone support 24 hours a day and on-site training for all CAPS/2020 users.
Premier Healthcare Exchange (PHX) was incorporated in 2001. The company provides advanced network management and claims integrity solutions for health plans. These solutions provide Payors with access to primary provider networks or to have custom networks created to fulfill the specialized needs of specific customers. Additionally, the PHX product suite combines claims processing automation with professional services to deliver a timely, centralized approach to ensure the integrity of a claim. This approach results in a significant reduction in payment errors, appreciable improvement in the time needed to bring claims to resolution and in savings that substantially reduce the healthcare costs of its clients. PHX solutions are utilized by industry leading insurance companies, Taft-Hartley Funds, Health Maintenance Organizations (HMOs), Third Party Administrators (TPAs) and healthcare providers.
These business partner relationships position the CAPS/2020 system for the "paperless" 21st Century. Only "problem" claims need to be reviewed; all other claims can pass directly from the electronic input stage to the electronic output stage without human intervention or the generation of printed documents.
You may also request a book that lists examples of many of the CAPS/2020 reports by writing us at Sales@CAPS2020.com
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