Benefits Of Insurance Module

• Comprehensive Benefit Detail

MC/2000 enables you to determine covered benefits, copays and limitations at the carrier, plan and employer group levels. Coverage can also be based on procedure and/or diagnosis codes.
 
 
• Age/Sex Benefit Validation

MC/2000 enables you to determine benefit coverage based on age and/or sex of member. In addition to validating encounter data and preventing inappropriate payment, this feature can also be used to monitor dependent eligibility based on age.
 
 
• Maximum Benefit Tracking

MC/2000 tracks specific procedures, within a time period, to ensure member does not exceed maximum benefit.
 
 
• Liability Identification

MC/2000 can determine liability to ensure that items outside of your financial responsibility are handled appropriately.
 
 
• Procedure Coverage Inquiry

MC/2000 allows on-line procedure coverage inquiry by carrier, plan, employer group or member. Used in conjunction with MC/2000's Membership and Eligibility Module, you are provided with the most current coverage information for individual members.
 
 
• Integration

Complete integration with Utilization Management, Claims Processing and practice management modules.

Back to Home