AMRHEALTH©

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AMR Group, I-CAPS, claims, managed care, HMO, PPO, POS, Medicare, Medicaid, administration, systems, health claims, payment, environment, integrated software, Intelligent Claims Administration System, I-CAPS, compliance, Advanced Value Scale, AVS, reimbursement, platform, membership, billing, enrollment, mailroom, claims, network, management, contracting, pricing, utilization review, customer service, Advanced Value Scale, AVS, data, intelligence, audits, fraud, coding, managed-care, entry, adjudication, edit, administration, billing, HMO/PPO, EDI, utilization management, clinical encounters, HMO, PPO, marketing, software, clients, elevate, physician, overcharges, technology, cost containment, healthcare
I-CAPS
is an Intelligent Claims Administration System that addresses all functional areas of the health claims payment environment with a single common architecture that sapns the needs of payers including membership, billing, enrollment, mailroom, claims, network management, contracting, pricing, utilization review and customer service.

RB-UCR puts responsibility back into physician fee schedules, geographically adjusted, including edits for bundling/unbundling. Documented and updated semiannually.

Since 1981, AMRHEALTH has been delivering health care solutions that address the needs within the managed-care environment including claims entry and adjudication, claims edit, group administration, billing and enrollments, HMO/PPO management, EDI, utilization management, clinical encounters, marketing, and provider relations. Our Triadic Operability™ Architecture merges complex functional processes with knowledge-based business rules to create Intelligent Software that thinks like your most experienced claims and health care professionals making decisions for you automatically. AMRHEALTH clients operate at higher efficiencies to spot physician overcharges, poor practice patterns while designing, building and administering plans that can now respond to health care challenges ... and contain costs.

Our Intelligent Claims Administration System (I-CAPS) and our coding compliance software (Advanced Value Scale-AVS) , support knowledge-based decision-making to help our clients contain costs. Guaranteeing the integrity of Provider information has never been easier with (Advanced Network Administrator-ANA) while our (RB-UCR) is the industries first Resource Based, Usual Customary and RESPONSIBLE fee schedule based on RBRVS and NCCI. Need a check up for your plan or provider, use Cost Containment Audit and Recovery Services (CCARS) for a completely non invasive audit retrospective look at claims effectiveness.

AMRHEALTH supports all forms of managed care and shared risk arrangements including: HMO, PPO, POS as well as Medicare and Medicaid.

 

AMR Group, AMR Health, AVS, claims, CAPS, managed care, HMO, PPO, POS, Medicare, Medicaid, administration, systems, health claims, payment, environment, integrated software, Intelligent Claims Administration System, I-CAPS, compliance, Advanced Value Scale, reimbursement, platform, membership, billing, enrollment, mailroom, claims, network, management, contracting, pricing, utilization review, customer service, Advanced Value Scale, AVS, data, intelligence, audits, fraud, coding, managed-care, entry, adjudication, edit, administration, billing, HMO/PPO, EDI, utilization management, clinical encounters, HMO, PPO, marketing, software, clients, elevate, physician, overcharges, technology, cost containment, healthcare
Advanced Value Scale (AVS) eliminates fraud and abuse with intelligent coding and compliance logic. AVS performs over 1 million defensible audit combinations identifying inappropriate coding and incorrect payments to control costs.


Product List:


I-CAPS - Intelligent claims Adjudication and Processing System

DENTAL - Dental Module for I-CAPS (posting 10-1, please check back)
ANESTHESIA - Anesthesia Module for I-CAPS (posting 10-1, please check back)
FLEX - Flexible Spending Accounts for I-CAPS
BILLING - Billing Module for I-CAPS (posting 10-1, please check back)
AVS - Advanced Value Scale
ANA - Advanced Network Administrator
RB-UCR – Resource Based, Usual, Customary and RESPONSIBLE
CCARS - Cost Containment Audit Recovery Services
LEB - Library of Employee Benefits (posting 10-1, please check back)


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