»» HCS Overview | HCS Advantages
Strategic Advantages
Reduce Operating Costs
Reduce operating costs and improve customer service by processing in real-time at the point-of service and using rule-driven architecture that supports individual needs.
Improve Customer Service
Improve customer service with faster and more efficient real-time point-of-service processing, a common engine used across benefit areas and the ability to check product, service and treatment suitability.
Enrolment & Eligibility
Enrolment & eligibility solutions effectively manage all groups, members and benefit recipients who are eligible for health care benefits. A single eligibility source drives all claims applications and administers all billing.
Dental Claims
Dental claims are managed and processed by the HCS Dental Adjudication System for dental health benefits by real-time EDI adjudication and manually submitted paper claims.
Pharmacy Claims
Pharmacy claims are managed and processed by the HCS Pharmacy Adjudication System for prescription drug benefits by real-time EDI adjudication or manually submitted paper claims.
Increase Competitive Ability
Increase competitive ability with an integrated environment that tracks and manages a range of health benefits or quickly check for suitable products, services and treatments. Utilize a common engine across benefit areas to handle inquiries better with less paperwork.
Adjudication
The HCS system is revolutionary for the health care industry in that it provides a single adjudication engine to drive four major adjudication systems, enrolment and eligibility and payment options.
Payment
Payment is adjudicated from all four claims sections through a single HCS adjudication engine.
Medical Claims
Medical claims are managed and processed by the HCS Medical Adjudication System for physician health claims by real-time EDI adjudication and manually submitted paper claims.
ESP-Link™/HCS Adjudication Engine
ESP-Link™/HCS adjudication engine drives all four major adjudication systems from a single powerful source.
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