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WHAT'S
NEW
HEALTHsuite®
& eHealthsuite™ |
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Following
are highlighted enhancements that have been incorporated
into the RAM solution suite (HEALTHsuite and eHealthsuite) as
part of Service Release 9.0 distributed on April 1,
2010.
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Enhanced Customer Service Capabilities
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Improved Interactive
Voice Response (IVR) Features
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Increased Coordination
of Benefits (COB) Processing
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Support for Provider
Taxonomy Codes
For
more information on this or any other product release
visit the Download area in our Customer Support Portal
and check the “Readme” and “Service Release”
documentation. |
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Enhanced Customer Service Capabilities |
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The
customer service capabilities of HEALTHsuite
have been dramatically expanded and allow health
plan representatives to log, track and route
inquiries and requests for service from all
constituent groups. Customer service
representatives can capture multiple requests
for service from a single contact, prioritize
them and can electronically attach any
information to the request (specific claims,
authorization information, benefits, bills,
payments, etc.) and route each component to the
appropriate individual or queue for review and
completion.
HEALTHsuite’s new Customer Service
capabilities embrace CRM philosophy and utilize
technology to organize,
automate, and synchronize business processes
allowing health plans to better service their
members, providers and employer groups.
See
Service Release 9.0.00 -- in the Service Release Folder
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Improved Interactive Voice Response (IVR)
Features |
HEALTHsuite’s Interactive Voice
Response (IVR) capabilities have been
streamlined and additional
verification has been added. This enhancement
utilizes web services to support eligibility
requests and claim status inquiries. Users submit inquiries via phone and
instantaneously receive responses with specific
information returned from HEALTHsuite to match their query.
See
Service Release 9.0.00 -- in the Service Release
Folder |
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Increased Coordination of Benefits (COB)
Processing |
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HEALTHsuite processing for both crossover and
dual-eligible Coordination of Benefits (COB) has
been enhanced to accommodate the application of
co-payments per admission for inpatient stays
(if applicable). This capability has been
incorporated into HEALTHsuite while insuring
that current COB functionality remains intact.
See
Service Release 9.0.00 -- in the Service Release
Folder |
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Support for Provider Taxonomy Codes |
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Support for
Taxonomy Codes has been added to Provider, Benefits, Fee Schedules,
Authorization and Claim modules.
The
Healthcare Provider Taxonomy Code (HPTC) is an
external non-medical data code set used to
classify health care providers according to
provider type and/or practitioner specialty.
See
Service Release 9.0.00 -- in the Service Release
Folder |
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