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E- Claims Management

MIMSYS claim module sends bills to insurance sites for approval. With this module you can create claims based on visit (All bills for a visit combined and send as a single claim)/Bill or separate claims for the following:

  • OP internal Bills
  • OP external Bills
  • OP Bills
  • Pharmacy bills
  • IP Bills

Pharmacy internal and Pharmacy external can be created and reports to a claim (Lab, Radiology, Histopathology, Microbiology, Cytology, Patient summary, Insurance card) can be attached. The Re-claim screen will allow sending rejected claims again for approval.

ELCIPSE

Electronic Claim Lodgment and Information Processing Service Environment (ECLIPSE) is an extension of Medicare Online claiming. Therefore offering a secure connection between:

  • Health professionals
  • Public and private hospitals
  • Billing agents
  • Private health insurers
  • The Department of Veterans’ Affairs
  • Medicare

It includes direct communication in the one transaction between health professionals, MIMSYS and private health insurers.

ECLIPSE can be used for both paid and unpaid inpatient medical claims and can be lodged directly through MIMSYS. Lodge in hospital claims from public and private hospitals and day facilities in relation to the patient’s hospital stay. This includes claims for accommodation, transfers, and miscellaneous items like prosthetics and the following claim types:

  • Online Patient Verification (OPV)
  • Online Veteran Verification (OVV)
  • Online Eligibility Check (OEC)
  • Status Request (STS)
  • OEC Reporting
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