The team at A1 Enterprise has just completed implementation for dental & vision insurance claims software in the education sector. This software has replaced a legacy MS Access database that was built in-house years ago with limited support and little flexibility for change or customization. This new implementation allows healthcare administrators to track dental and vision plan participants and their enrolled dependents which can then help validate their enrollment status while processing claims.
The team at A1 Enterprise collaborated closely with their customer in the education sector to streamline and configure the claim data entry process to simplify it as much as possible, thereby reducing the steps in the claim process. Throughout the installation, the A1 customer collaboration effort held strong to analyze claim reimbursement and reporting requirements and ensure the claim reimbursement amounts computed correctly based on the claimant plan coverage.
Business rules and computation logic are critical features of A1 Tracker’s products, and they allow the system to automatically generate claim reimbursement amounts based on their allowed coverage, prior policy year claims, and coverage limits. Users have access to real-time claim summary reports, reimbursement totals, and explanation of benefits (EOB) reports for claimants. The implementation that A1 Tracker offers will send EOB reports automatically to claimants along with their claim totals and remaining reimbursements for the plan year. Each year, the customer can also manage plan enrollment using a batch file of employee names generated from a compatible HR payroll system. This feature, combined with the other automated capabilities of this implementation, saves company time and resources while providing excellent product support. That is a valuable resource for any organization with outdated dental & vision insurance claims software.