Employer Medical Reimbursement Claim Software

A1 Tracker has been awarded a new MERP Employer Medical Reimbursement Claim Software implementation that will be used to track medical claims, expenses, services, plans, and benefits for employers. This implementation will cater to an organization that manages medical expense reimbursement plans (MERPs). This implementation will cover medical claims management and medical insurance policy, plan, and benefits management.

A1 Tracker software flexibility allows both internal and external users to access parts of the application after receiving permission to by the Administrator(s), which will be based on role, clients, department, and job function. This will ensure that users can only view and perform tasks within their privileges.

A1 Tracker MERP employer medical claim reimbursement software will be customized per client requirements and tailored to specific client needs. The implementation team will consist of key members from both the customer and A1 Enterprise technical team. The A1 Enterprise portion of the team will cultivate collaboration to specifically define the business rules, benefits management programs, claim benefit calculations, and a client portal with reporting.

This medical claim software will include several key modules of A1 Tracker:

1- Contact Management: To create and manage client companies (employer groups), members (employees), dependents, insurance carriers, claims, and adjusters to name a few.

2- Insurance Policy Module: To create and manage insurance policies, plans, and benefits. Benefits include both medical services and pharmacy benefits, as well as producing pharmacy benefits cards for members. As this customer is a MERP provider for employers, each policy and plan is designed uniquely for each client. That means that polices and plans will not be selected from a set of pre-configured insurance plans like what is used for most companies that re-sell insurance plans. Therefore, the flexibility and configurability of A1 Tracker will be instrumental in a successful implementation.

3- Claims Module: To create and manage medical insurance claims, generate claim reports, and process claim benefits and reimbursements. A1 Tracker will offer a set of reports that can be generated by a single click, including the Explanation of Benefits reports (EOB), claims summaries, member report, and a member Rx ID card. Some of these reports will also be available via a self-service employer/employee portal.

Business logic will control insurance claim benefit reimbursement amounts, which will be determined by plan benefits and medical service codes. When submitting claim expenses, A1 Tracker will automate the process of assigning a claim reimbursement by comparing annual plan benefits to year-to-date benefits, out-of-pocket expenses, co-insurance, and deductibles. A1 Tracker benefits tables can store an indefinite number of variant benefits and coverage, giving plan administrators space to design plans that best meet client needs.

A1 Enterprise will also provide this customer with a customized and cutting-edge insurance claim software portal to update medical claim details and manage medical claim expenses and services. This medical claim portal will bring together all of the key claim components users require on a daily basis to manage claims, allowing them to easily and efficiently work with these components from within a single screen. A1 Enterprise will collaborate with this key customer to ensure the medical claim portal interface best caters to the usage needs of their users and target how they will use A1 Tracker on a day-to-day basis.

Another key feature of A1 Tracker employer medical claim reimbursement software is document management. Documents will be added using a simple drag-and-drop module, as well as managing notes, claim letter templates, email notifications, and reminders.

Contact us for a free demo and more details about employer medical claim reimbursement software.