Complete Claims

Complete Claims

Complete Health Systems
InsightPro.ai

InsightPro.ai

MDI NetworX
+
+

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About

Claims Adjudication for medical, dental, vision, prescription, short and long-term disability claims. Available for on-site license or as a hosted application (ASP). Microsoft technology: SQLServer database with a Windows front end. Acclaimed Customer service staffed by health care claims experts with a minimum of 12 years’ experience in the field. Support calls are logged with status available via the internet. Plan copy and modification feature enable quick setup of plans. Auto-adjudication using benefit codes built using business rules based on over 25 variables from both the claim and the claimant records made available to the adjudication engine. Inbound claims can be scanned images, EDI or paper. HIPAA EDI 5010 transaction sets. Re-pricing fee and UCR Schedules can be loaded on the system in advance of the effective date. The date-driven logic will re-price based on the date of service.

About

InsightPro is a web-based workforce analytics and operations platform for health insurance payers, third-party administrators, benefit administrators, and health plans. It supports claims operations, quality assurance, and member contact-center teams. Claims features include inventory tracking, task assignment and distribution, production planning, forecasting, KPI dashboards, activity monitoring, and query resolution. Quality teams can use configurable audits, sampling, capacity planning, error feedback, rebuttal workflows, and performance reporting. Contact-center features include member and call-history views, configurable workflows, real-time highlights, and performance analytics. Workforce dashboards help managers monitor productivity, workload, quality, and operational trends, while administrative tools support user and workflow management. The platform is delivered as a configurable SaaS service for payer operations; plan scope and pricing are tailored to customer requirements.

Platforms Supported

Windows Not Supported
Mac Not Supported
Linux Not Supported
Cloud Supported
On-Premises Not Supported
iPhone Not Supported
iPad Not Supported
Android Not Supported
Chromebook Not Supported

Platforms Supported

Windows Not Supported
Mac Not Supported
Linux Not Supported
Cloud Supported
On-Premises Not Supported
iPhone Not Supported
iPad Not Supported
Android Not Supported
Chromebook Not Supported

Audience

Businesses in need of a tool to manage their claims adjudication processes

Audience

Health insurance payers, third-party administrators, benefit administrators, and health plans; used by claims, quality assurance, member services/contact-center, and operations teams.

Support

Phone Support Supported
24/7 Live Support Not Supported
Online Supported

Support

Phone Support Not Supported
24/7 Live Support Not Supported
Online Not Supported

API

Offers API Not Supported

API

Offers API Supported

Screenshots and Videos

Screenshots and Videos

Pricing

No information available.
Free Version Not Supported
Free Trial Not Supported

Pricing

Flexible payment options include monthly plans and pay-per-transaction billing. SaaS pricing is tailored to selected features and customer requirements; no long-term commitment is required.
Free Version Not Supported
Free Trial Not Supported

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

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Review this Software

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Training

Documentation Not Supported
Webinars Not Supported
Live Online Not Supported
In Person Not Supported

Training

Documentation Not Supported
Webinars Not Supported
Live Online Not Supported
In Person Not Supported

Company Information

Complete Health Systems
completehealthsys.com/claims/

Company Information

MDI NetworX
Founded: 2014
United States
insightpro.ai/

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Categories

Claims Processing Supported
Health Insurance Supported

Categories

Integrations

No info available.

Integrations

No info available.
Claim Complete Claims and update features and information
Claim Complete Claims and update features and information
Claim InsightPro.ai and update features and information
Claim InsightPro.ai and update features and information