Enterprise Transactions Dispatchers consists of a series of secure, customizable web-based front-end tools that allow providers to interact with health plans, hospitals or clearinghouse for all their transactions. Front-end tools available are:
Eligibility Dispatcher is a front-end tool that enables providers to submit online eligibility inquiries that are routed to the appropriate payer’s eligibility database. This application returns an immediate response on a covered individual and plan details eliminating the need for a telephone enquiry. Also available are member rosters and panel listings.
Case Management Dispatcher is an application that allows, referring providers, specialists and payers to exchange referrals, pre-certifications and authorizations over the web. This tool acts as an intermediary between the referring physician, the specialist and the hospital. The system manages the utilization of covered services and member eligibility.
Enrollment Dispatcher is a member enrollment front-end that allows employees, health plan members etc. It has batch plug-in capabilities for popular HR systems including SAP and PeopleSoft. This tool eliminates the need to mail enrollment forms.
Dispatchers are also available for: claims, claim status, remittance advice, pharmaceutical and financial transactions.
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