Members Management

Members Database

Cover/Product Database

Group & Individual Contribution Billing

Agency Administration Module (Optional)

Customer Service Notes System

Correspondence Module Features

Claims Processing Modules

Claims System Versatility

Claims Administration & Assessment

Claims System Summary

Reasonable & Customary Charges

Electronic Claims Processing

Dental Claims Module

Pharmaceutical Processing Modules

Claim Adjustment & Cheques Cancellation

Cheques & Remittances Advice

Report & File Generation



Claim Adjustments and Cheques Cancellation

Adjusts previously processed claims on-line in a real-time mode
Paragon21 allows authorised users to adjust previously processed claims on-line in a real-time mode.  Once an adjustment is made, the system automatically calculates and updates the benefits for the claim and updates claims history.  The results of the adjustment calculation are immediately available.

Any adjustments are immediately reflected on the screen.  The system instantly updates benefit history information so the correct balance is immediately available.

Paragon21 allows authorised users to:

Void an incorrect claim.  

Re-process a voided claim to eliminate the information.  

Cancel a benefit cheque when the user knows the cheque will never be cashed.  

Re-issue a cheque without the need to re-enter any valid information.  

Create a reimbursement transaction when money is returned from a claimant or provider.  

A complete audit trail is kept for all transactions with date, time and operators ID stamps.  

History Adjustments (e.g. Dependants, Dates of Service).  

Balance Payment (Make further payments to payee).



For more information or to organise a demo of the Paragon21 Package,
Please contact
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