Medicare Supplement Auto-Adjudication
Medicare Supplement Claims Auto-Adjudication
Administer all Medicare Supplement plans in every state for Parts A and B with 24/7 processing. Key system features unique to QLAdmin enable easy product maintenance without the need for custom programming.
QLAdmin offers complete policy administration processing for each phase of the policy lifecycle with real-time financial and non-financial processing and automated daily system cycles. Easy to use tools enable flexible plan code maintenance, rapid product rate changes, and customized agent and commissions management. Trust QLAdmin to save you time maintaining your current business enabling you to focus on achieving your future goals.
Medicare Supplement Products Supported
- All Medicare Supplement plans
- All states, including Wisconsin, Massachusetts, and Minnesota
- Al benefits, including coinsurance, excess amounts, and foreign travel
Key Auto-Adjudication Features
- Claims engine dashboard with performance metrics
- Business rules engine for benefit and procedure mapping
- Manual claims queue with one-click re-adjudication
- Rate increase filing and implementation management
- New business and e-app import via ACORD file integration
- EDI file integration with clearinghouse and EOB/payment vendors
Fully Automated
Claims Adjudication
Clearing house data file integration includes eligibility verification, duplicate claim checking, data scrubbing, and Explanation of Benefits and payment file creation.
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