TPA Claims Management Software Solutions

MedinyX is a complete TPA (Third Party Administrator) solution for claims management system. It is designed to enable automated health benefits administration and claim adjudication. An improved user experience, improved patient care standards, significantly reduced administrative costs, and much more can all be achieved while adhering to all regulatory standards.

Our product can easily adapt to any existing infrastructure. The software can be customized with any third-party application to meet the market's ever-changing demands.

MedinyX TPA Claims Management System offers influential advantages to enhance the velocity and effectiveness of claims preparation and settlements further escalating client administration and fulfillment levels.

TPA

MedinyX TPA Platform Modules

Accounts / Finance

  • Payments
  • Deposit
  • Advance
  • e-Approvals

Admin

  • User Rights
  • Office & User Configuration
  • Currency & Country Configuration
  • Admin Eye & Email Rights

Credit Control

  • Party Ledger
  • Days Interval Outstanding
  • Payment Settlement
  • Followups & Email reminder

Client Portal

  • Portal for Hospital
  • Portal for Customer
  • Portal for Insurance Company
  • Portal for Assistance Company

Claims Payment

  • Claim Adjudication
  • Claims Audit & Investigation
  • Running Claims / Pending Claims
  • Claim Payment Verification
  • Closed Claims

Claim Operations

  • Claims Itntimation
  • Claim Dashboard
  • Claim Auditing
  • Documents Verification and Uploads
  • Claim Verification and Claim Registration

Invoicing / Billing

  • Invoicing to Insurers
  • Invoicing Approval
  • Multiple Currency
  • Provider Billing

Preferred Providers

  • Preferred Providers
  • Pre Agreed pricing
  • Discount and Negotiation

Policy Management / Member Enrollment

  • Policy/Plans Configuration
  • Policy/Plans Benefits & Limits
  • Checklist for Policy Benefits
  • Bulk Enrollment - Excel
  • API Enrollment - XML, API

Improve The Productivity and Efficiency of Your TPA Operation

Multiple Currency

Multiple currency management

Claim

Claim dashboard

Notification

Automated alerts and notification

Tailored

Tailored workflow as per your requirements

Claim Cycle

Reduce the claim cycle time

productivity

Claim process automation

Platform Screenshots

Diagnosis

ICD-10 Diagnosis

Invoice

Provider Invoice

MCC

MCC Invoice Details

Dashboard

Claims Dashboard


Some of the key features of MedinyX TPA system

  • Claim notification and automotive response in minimum time to the client.

  • Claim Registration and Verfication

  • Claim management system holds the ability to remind the urgent and pending claims on the group and individuals.

  • Full provider network database with integrated map service.

  • Handling of claims requests.

  • Insurance claim management software have the ability to store large number of data related to the claim whether medical, financial or network related.

  • All communications - documents and logs stored directly on the related claim.

  • Ability to share the files with individuals and groups at the same time.

  • Has real time currency exchange features.

  • Templates for all outgoing communications.

  • Allows files to transfer and share with different dept. for billing, networking and Auditing purpose.

  • Claim management system's ability to share the Medical information with medical dept. and to avail their authorization and recommendation online on the critical medical cases.

  • Online authorization features.

dashboard
Destop

Book a demo today to search out what your
future might look like