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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 spans the needs of payers including membership, billing, enrollment, mailroom, claims, network management, contracting, pricing, utilization review and customer service. |
Since 1981, W.O.
Comstock & Associates 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. Our clients
can operate at higher efficiencies with the ability to spot physician overcharges,
and poor practice patterns. They can also design, build and
administer plans that can respond to health care challenges while containing costs. |
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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. |
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