Managing the health and dental plans of any business is a difficult undertaking. But as an insurance company, what are your benefit adjudication needs?

SECURITY
We have designed Adjudicare to meet the industry’s client information reporting standards. Within its reporting metrics, Adjudicare actually scrambles the client order to comply with Canada’s legal requirements for keeping patients’ medical information secure. This ensures that no matter who is using the software for reporting, confidential client information is never comprised.

TECHNOLOGY
With an insurance company’s size, it’s a given that any number of software systems are being run at the same time. With so many programs handling such sensitive information, it’s important that the software applications you use are secure. How does the Adjudicare system achieve this? The full story can be found in our Technical Capabilities flyer.

INTEGRATION
Adjudicare’s integration capabilities are fully realized on two levels. There’s the integration of the Adjudicare software system with existing client applications which allow different members of your organization to utilize the information stored in Adjudicare. So, different stakeholder groups, like your accounting department or customer call centre, can retrieve claim payment and claimant information for use in their own departmental software programs.

Adjudicare also has the ability to fully integrate with other software systems being run internally. The software fully integrates with other third party providers, pay direct drug cards or electronic dental service providers, on a real-time basis to manage eligibility and retrieve and pay claims. This seamless solution for data exchange and report generation makes life even easier by importing claims history from other third party providers into the Adjudicare software. Reporting has never been easier.

CONSOLIDATION
Ready to bring continuity into your claims management system? The Adjudicare system brings multiple pieces of your claims management puzzle under one roof, simplifying your data management.

REPORTING
Adjudicare offers a full range of reports designed to give its clients a customizable view of claims activity. Anything you need can be done. Reports are immediately available to you and the only charges you'll incur will be from custom-built reports run specifically for you.

PLAN MANAGEMENT
Two key features of the Adjudicare plan management functionality are important to note. Not only does it manage multiple, complex plan designs, it also monitors and manages all back end data internally. This keeps the data fully accessible, fully usable and fully owned by you.

PAYMENT SOLUTION
Adjudicare offers a fully integrated payment solution for its clients. Claims can be paid from a core plan, HSCA or cost plus program, improving how you manage and pay your claims.

SELF-PROMOTION
Adjudicare is a “white label” solution. Simply put, this means that all reports, payment cheques and drug cards issued by you will have your logo on them, not ours. This means that no other brand will come between you and your end client.