HPS Professional
HPS Professional is a web-based application to maintain and manage the entire practice.
HPS Professional enables the providers and administrative staff login at any time from any place as long as there is internet connectivity. All HIPAA mandated transactions are built in the system. Eligibility and Claims transmissions can be achieved through EDI (Electronic Data Interchange).
Features
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Setting up doctors' availability (to conform patient appointments accordingly)
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Schedule office visits for multiple providers
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Patient demographic information
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Patient ledger maintaining billing and receipts
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Maintain encounter (visit) details
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Maintain billing and payment details
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Setup custom diagnosis and procedure codes mapped to code set rules
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Accept credit card payments and post to patient ledger
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Maintain capitation payments for pre-paid plans
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Maintain details of group name and list of providers with details
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Generate insurance and patient statements
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Generate multiple reports on billing and collection
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HIPAA compliant EDI transactions such as sending eligibility requests, claim status requests and professional claims
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View eligibility responses, claim status responses, remittance advices in readable templates
HPS Total Administrator
HPS Total Administrator is a client-server based product designed to meet Welfare & Benefit administration of self-insured entities such as ERISA (Taft-Hartley) funds.
Features
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Adjudication of Medical, Hospital and Dental claims
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HIPAA-compliant EDI transactions
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Master Contract maintenance and renewals
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Contribution accounting and eligibility
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COBRA compliance
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Pension/Annuity plan administration
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Disability and Death Benefit administration
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Member service management
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Union membership maintenance
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Provider credentialing
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Medical Director review
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Master files including all Code sets and many other features
HPS Clearinghouse
HPS Clearinghouse is fully HIPAA compliant for transmission of electronic files between healthcare providers and payers.
We are one of the industry's leading clearinghouses for self-insured payers. We transmit both batch and real-time transactions.
HPS Clearinghouse is your all-payer, all-provider solution for electronic transactions.
The clearinghouse provides a highly-secured, and smooth transmission of files between providers and payers, both commercial and government payers.
HPS Clearinghouse is certified for all HIPAA transactions by Claredi.
HPS Tandem
HPS Tandem is a web-based product designed to manage all EDI transactions.
Features:
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Sends Eligibility Inquiry Request (270)
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Receives Eligibility Benefit Response (271)
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Sends Claim Status Request (276)
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Receives Claim Status Response (277)
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Sends Health Care Dental Claim (837D)
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Sends Health Care Medical Claim(837P)
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Receives Explanation of Benefits (835)
HPS EDI Interface
HPS EDI Interface is designed to use with any Practice Management Software (PMS) for implementing Electronic Document Interchanges as mandated by HIPAA.
HPS EDI Interface is an ActiveX Component that allows end-users to send and receive HIPAA EDI streams. It takes care of all the data interchanges, privacy, and security requirements of HIPAA and helps the developers of PMS software to concentrate on other important application-specific tasks.
Features
Sends Eligibility Inquiry Request (270)
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Receives Eligibility Benefit Response (271)
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Sends Claim Status Request (276)
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Receives Claim Status Response (277)
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Sends Health Care Dental Claim Request (837D)
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Sends Health Care Medical Claim(837P)
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Receives Explanation of Benefits (835)
Sterling EDDIE
Sterling EDDIE is a light weight desktop tool designed to enable providers send and receive HIPAA compliant EDI (Electronic Data Interchange) transactions with their existing Practice management software.
Features
Allows continued use of existing Practice Management Software
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Enables existing PMS (Practice Management Software) to support EDI (Electronic Data Interchange) transactions
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Contains templates for ease of entry of outgoing transactions and read the incoming transactions.
Medical Review Desk
Medical Review Desk is a web-based tool that can help Medical Directors of Health Plans and Senior managers to obtain critical information on their fingertips. The site contains details of all procedure codes - CPT and HCPCS along with rules on application of various edits.
The following look up is available for each procedure code:
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Applicable Diagnosis codes
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Applicable CCI Edits (Unbundling codes)
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Applicable anesthesia code and Base unit
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Applicable claim rules such as Bilateral procedures, Multiple procedures, Assistant Surgeon, Team surgeon, etc.
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J Codes for medications with corresponding NDC codes
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Medicare RBRVS details for each code with fee for each geographical location
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NPI look up and search for providers
Member Web Enrollment
Member Web Enrollment is a product designed to permit online enrollment by participants. This allows easy method for the participants to enroll and choose different types of health plans by secure login.
Features:
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Online member enrollment
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Maintenance of member demographics
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Maintenance of dependent information
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Maintenance of other health coverage information
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Maintenance of beneficiary information
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Maintenance of working spouse authorization details
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Plan selection - type of coverage
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Enrollment and authorization of payroll deductions, if any
Online Employer Contribution
Online Employer Contribution is a web-based product designed to reduce the burden of collecting employee work hours and wages from the Employers. Both the Employers and the Fund can benefit significantly by use of this service. Login is created for each employer to report the list of employees along with work history and wages as frequently as required. The Fund administration can view all employers associated with the fund and receive the information for download to the HPS-TA system. This reduces the data entry time and expense involved while reducing error.
Features
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Maintenance of employer information
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Maintenance of participant information
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Maintenance of dependent information
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Maintenance of employer payment details
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Maintenance of employer contribution details
Online Provider Credentialing
Credentialing is a web-based application designed to suit both managed care and hospitals to perform credentialing and re-credentialing of providers in a fast and efficient manner at a reduced cost. The information obtained for Credentialling include:
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General Information
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Education and Training
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Professional Societies
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Practice Information
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Confidential Professional Information
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Hospital Privileges
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Professional Liability History
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Professional Liability Insurance Carriers
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Administrative and Billing Information
Features
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Role of Credentialing for provider
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Detailed data collection on each provider
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Primary source verification
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Letter writing and report generation
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Re credentialing - application print-out using available data
Online Member Portal
Members Portal is a web-based product designed to help participants to maintain their information and to get to know about their Eligibility & Benefit details online.
- Online maintenance of participant's demographic information
- Online maintenance of participant's other coverage information
- Online maintenance of participant's dependent & beneficiary information
- Online lookup of claims and claim statuses
- Online lookup of eligibility details
- Online lookup of pension and annuity benefits
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