Transaction Portal®

Transaction Portal®

Transaction Portal® is a web-based Transaction Portal built to interface with any Managed Care application like Facets, QNXT or MC400. Designed as a state-of-the-art solution and developed using Microsoft Visual Studio, it is intended to be hosted on a recent Windows Server with the .Net Framework and SQL Server.

A multitude of features are available including:

With support for Single Sign-on using NTLM or Active Directory logon, Intranet users are automatically authenticated without the need to supply new credentials. Using Role-based security, it is easily configurable for various user types, presenting a custom set of tailored navigation and features.

Transaction Portal® was built with Internet security in mind to prevent malicious SQL Injection type of intrusions.

Includes sophisticated functionality designed for Claims Examiners to resolve and reprocess claims that fail to adjudicate. There are multiple electronic reports for verifying claims and batches.

Supports any command line based HIPAA transaction mapping software like Sybase Neon Maps and others for 5010 HIPAA transactions.

Facilitates secure transmission of HIPAA transactions from remote clients to the Transaction Portal® Server. Currently supported transactions are:

  • 820 Premium Payment inbound
  • 834 Benefit Enrollment inbound
  • 837 Claims inbound and outbound

Multiple 837 Transaction Processing Types are supported for both Institutional and Professional transactions.

  • Fee-For-Service Claims
  • Pharmacy Claimss
  • Encountera
  • Encounter Reprocessing

The Portal Home page demonstrates support for:

  • Upload HIPAA Transaction Files
  • Batch Header Search
  • Claims
  • Encounters
  • Pharmacy
  • Claims Inquiry
  • Batch Transfer
  • Provider Search
  • Administrator Functions

Supports generation and tracking of letters such as ACK, AOR, RFI, Extension and Resolution using client maintained templates with attachments, retrievable PCT database values and free fields (text, date and time, checkbox) that can be dynamically added to the correspondence action item forms which allow user entered values to be inserted into the letter templates when the letters are requested.

Ability to group letter templates by letter type, line of business, member's state and language to display only the relevant templates in correspondence action item forms.