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Insurance & Claims Management with Eclipse integration

The MIMSYS Hospital Management System is designed to handle multiple insurance processing requirements and protocols.

Department eligible services can be configured, pick co-payment percentage at sheet level or detail level, fix patient deductibles based on annual or per consultation visit basis and force pre-authorisation by the insurance provider when the amount exceeds a pre-defined limit for a bill or an individual item.

Discounts can be given at sheet level or at detail level. All claims related activity such as rejected, accepted or settled among others, is tracked and can be viewed on a real time basis.

Reminder alerts are given for patient set up, and patient balance, as well as family balance, can be tracked.

Payment can be received in multiple modes and is integrated with Banks, Accounts Receivable as well as General Ledger modules of SAGE 300.

  • Verify insurance eligibility and benefits.
  • Configure department wise eligible services.
  • Select co-payment percentage at patient-level or detail level.
  • Fix patient deductibles based on annual or per consultation visit basis.
  • Ability to require pre-authorisation by insurance provider when the amount exceeds a predefined limit for a bill or an individual item.
  • Track and view all claim related activities in real-time.
  • Combine all claims into a single claim for a patient and send it to the patient’s payer for approval.
  • Medicare online claims with Eclipse Integration.
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