Exela provides innnovative healthcare solutions to speed up processing and streamline enrollment, adjudication, and reimbursement
Healthcare Insurance Solutions & Services
Exela provides innnovative healthcare solutions to speed up processing and streamline enrollment, adjudication, and reimbursement
Quote to card
Secure, web-based platform for effectively managing healthcare enrollments and documentation
Member installation
Nurse guidance and advice
Scheduling appointments
Insurance verification
Dashboard analytics: view by provider/facility/date
Real-time visibility into pharmacy insurance coverage
Credentialing
Contract management
Installation
Accomodate large volumes of claims electronically or via mailroom
Single channel for paper and EDI
Mailroom: sorting, scanning, data capture
Data verified and pre-claim edits → clean claim
Real-time notification and visibility of any deficiencies and status of claim
Client-specific validation
Clean claims
Business rules integration | pre-edits | authorisation
Contract fee schedule
Remittance/payment
Explanation of benefits/liabilities mailed
Exception management
ePresentment of denials
Nurse review
Customised compliance audits
Consistent rule updates
Claim checked against contract database for optimal billing
Paper or electronic transactions and lockbox (BancHub)
Manage reports
Adjustment
Daily deposit log
ERA conversion
Overpayment identification and recovery
Dashboards and solutions-driven reports using big data analytics
Predictive analytics
Claims-related inbound and outbound call centre support, with 24/7 coverage
On-premises and/or cloud-hosted
Security and compliance
Amendment tracking
Summarisation and dashboards
Live or virtual agent
Patient outreach and disease management
FAQ
EOB correspondence: print and mail
Billing automation (payment by IVR)
Scheduling and support
Mobile apps
Pre-delinquency, third party debt, and legal collections
Credit reporting
Quote to card
Secure, web-based platform for effectively managing healthcare enrollments and documentation
Member installation
Scheduling appointments
Insurance verification
Dashboard analytics: view by provider/facility/date
Real-time visibility into pharmacy insurance coverage
Credentialing
Contract management
Installation
Accomodate large volumes of claims electronically or via mailroom
Single channel for paper and EDI
Mailroom: sorting, scanning, data capture
Data verified and pre-claim edits → clean claim
Real-time notification and visibility of any deficiencies and status of claim
Client-specific validation
Clean claims
Business rules integration | pre-edits | authorisation
Contract fee schedule
Remittance/payment
Explanation of benefits/liabilities mailed
Exception management
ePresentment of denials
Nurse review
Customised compliance audits
Consistent rule updates
Claim checked against contract database for optimal billing
Paper or electronic transactions and lockbox (BancHub)
Manage reports
Adjustment
Daily deposit log
ERA conversion
Overpayment identification and recovery
Dashboards and solutions-driven reports using big data analytics
Predictive analytics
Claims-related inbound and outbound call centre support, with 24/7 coverage
On-premises and/or cloud-hosted
Security and compliance
Amendment tracking
Summarisation and dashboards
Live or virtual agent
Patient outreach and disease management
FAQ
EOB correspondence: print and mail
Billing automation (payment by IVR)
Scheduling and support
Mobile apps
Pre-delinquency, third party debt, and legal collections
Credit reporting
