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



Claims System Versatility
Easy to use, sophisticated claims assessment and reporting capabilities
Paragon21 Claims Modules provide easy to use, sophisticated claims assessment and reporting capabilities.  Using step-by-step procedures and easy to follow screens, users can perform all the functions required to assess claims.  In addition, access to the latest information in an on-line, real-time mode is available.
Significant Strengths


Performs operations through easy to follow screens. 
(The system displays functions in a logical, consistent manner on easy-to-use tabs.)

Retains a complete copy of all correspondence with a claimant or provider. 
(The system allows immediate on-line access to this information.)  

Utilises the mouse or command keys that minimise keystrokes and allows the user to go directly to the next processing step without having to type commands.  

Uses concise (English) field descriptions and avoids ambiguous codes and field titles.  

Verifies field entries and transactions.  (The system displays messages and/or screens when additional information or acknowledgment is required.)  

Bypasses certain screens that may not be needed every time a claim is entered. 
(The system (via passwords) allows the System Administrator to determine which screens and/or buttons within a screen are available or bypassed.)  

Accepts user-defined information and free-form notes in designated text areas.  

Retains claim history information on-line, based on user requirements.  

Provides access to information through the member number, member name (or part of), claim number, or providerís name, etc.  

Provides real-time validation of Provider type and service provided.  

Has body part identification (e.g. tooth number, etc.).



For more information or to organise a demo of the Paragon21 Package,
Please contact
Copyright © 1999 Paragon21

This site is being designed, developed, maintained
and hosted by
Network Logic