AdminisTEP Features

AdminisTEP enables healthcare organizations to increase claims throughput, and more efficiently manage claims transactions by resolving errors when they occur. Plus, AdminisTEP streamlines the handling of non-claims transactions — correspondence, medical records, and more — to lower payor's administrative costs, increase provider efficiency and boost everyone's productivity.

Click on the bars below to view details about each AdminisTEP offering.

 

  • Real-time and batch transaction interfaces
  • Claim reconciliation
  • Electronic funds transfer (EFT)
  • Denial management
  • Online claim edits
  • Perimeter Processing — Front-end management and pre-adjudication business rules to provide real-time processing results to providers and payors about rejections
  • Transaction visibility and auditing from submission receipt to extract
  • Transaction consolidation
  • Transaction inventory management
  • EFT for remittance payment
  • Correspondence, conversion and tracking
  • Syntax Rules — This fundamental type of business rule validates that the EDI transaction structure complies with current standards (e.g., 4010A1, 5010, D.0., etc.) and that data fields are populated with the right data types in terms of character length, character type (alpha vs. numeric), etc. Syntax rules validate X12 file formats, including data elements, segments and functional groups (e.g. ISA, GS, ST, SE, GE, IEA, UNA, UNB, UNG, UNZ, UNH, UNT, UNE).
  • Core Rules — Validate that required data elements are present and properly formatted. These elements include national provider identifiers (NPIs), member number and information, provider physical and billing addresses, claim type information, and much more.
  • Revenue Cycle Management — This is where AdminisTEP is differentiated from other vendors. Once AdminisTEP has your claim data, it can be sorted, reported and workflowed any way you want it. These business rules are quickly customized to your specific needs. AdminisTEP delivers the results you want, from automating the handling and reporting of claims inventories, to creating rules that help manage chronic conditions and population health.
  • Evaluate critical business variables as they relate to market conditions
  • Generate member population statistics using claims data to identify areas needing improvement and new product line opportunities
  • View trending data to monitor business line performance and cost variance
  • Chronic care management, disease management, and population health management
  • Provider network management
  • Employer and member utilization
  • Data warehousing
  • Customized analytics solutions based on claims data analysis to fit your requirements
  • Manage claim exceptions (errors and rejects) with robust workflow
  • Automate processes, create digital transactions, increase pass rates, eliminate human touch points
  • Framework with client-specific customization
  • Data Verification Review (DVR)
  • Correspondence Data Management (CDR)
  • Provider Data Management (PDM)
  • Medical Record Management (MRM)
  • Data Correction Review (DCR)
  • Claim Re-pricing Management (CRM)
  • Payment Policy Management (PPM)
  • HIPAA transaction/code sets and security infrastructure
  • Timely management of appeals, grievances and correspondence within regulations
  • Fraud detection business rules
  • Real-time transaction processing
  • Provider-payer host system integration
  • Virtual private network (VPN)
  • Electronic funds transfer (EFT)
  • Member, provider, payor services portal
  • EMR/EHR integration
  • Mailroom
  • Claims processing and adjudication
  • Member and provider services
  • Member data management
  • Provider data management
  • Compliance management
  • OCR technology for paper conversion to electronic transaction (paper claims, paper remittance advice)
  • Online views and printing for claims and remittance advice
  • Easily scan, store, search and view any correspondence (medical records, enrollment forms, health assessments, etc.)
  • Online claim and electronic remittance advice (ERA) management
  • Online re-submission of rejected claims
  • A convergence point for all claim and electroinic remittance advice processing
  • Online standard paper claim form for direct data entry
  • Online non-standard paper claim form for direct data entry
  • Online remittance and claim reconciliation
  • Online electronic remittance advice viewing and printing
  • Claim data reporting
  • Transaction inventory totals
  • Statistical analysis
  • Error tracking and reconciliation
  • Turnaround-time tracking
  • Input/output reconciliation
  • Control point reconciliation
  • Historical analysis
  • User productivity
  • Work history detail and tracking
  • Translate any transaction format to any format
  • Standard X12 formats
  • Non-standard formats (XML, flat file)
  • Non-direct interfaces (gateway and clearinghouse interfaces)
  • Secure FTP for secure transmission
  • Manual uploads and downloads via the portal
  • Automation for uploads and downloads
  • Business rules applied to claims before payor submission
  • Front-end rejecting process for immediate acknowledgement to payors-providers
  • Host independent (PMS/billing systems and payor claims system)
  • Direct transmission and receipt of transactions from participating payors
  • Online tools to manage transactions
  • Eligibility verification, claim status and remittance
  • Manually input claims data for electronic submission to payors
  • Menu-driven prompts guide providers through data-entry screens
  • Screens look like CMS-1500 and UB-40 forms
  • View electronic rejection letter and remittance from payors
  • Manage claims electronically
  • Business edits applied to claims before payor submission
  • Online standard paper claim form for direct entry
  • Online non-standard paper claim form for direct entry

This is us

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Smart doctors.
Practice intelligence.

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2600 Technology Dr.
Suite 700
Plano, TX 75074

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The industry's most robust set of business rules. Take action. Recover revenue.

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888.751.3271

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Clearinghouse services. Intelligent transaction routing. Data accountability.

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info@administep.com