HPS (Health Plan Systems, Inc.) creates exceptional healthcare administrative software for all stakeholders in the healthcare industry – Unions & Self Insured Funds, Insurance Companies, Third Party Administrators, Hospitals, Doctors, Practitioners and Healthcare Consumers. Our softwares are full featured, secure and very easy to use. Our softwares have the full range of features and go through a thorough security and compliance checks. Our softwares are fully certified as HIPAA compliant by Claredi (now Ingenix), a third-party organization that accredits entities which send, receive or process HIPAA regulated electronic transactions.
Our flagship product, HPS NOVUS is currently utilized by self-insured health plans functioning under the Employer Retirement Income Security Act (ERISA), as well as by Third Party Administrators (TPAs). HPS has established a Clearinghouse for secure transmission of HIPAA compliant Electronic Data Interchange (EDI). HPS is committed to serving self-administered health plans and has been helping to provide electronic administrative solutions to union welfare funds for more than 20 years. HPS operates at the intersection of cutting-edge technology, strategy and Intuitive design. Also, HPS constantly keeps up with regulatory changes and upgrades its software to achieve complete compliance.
Finally, our exceptional high-performance software solutions are backed by passionate customer service.
HPS has never lost a client to competition. HPS partners with our clients to formulate a solution that best fits their current and future requirements. Our solutions are marked by inherent scalability and can be deployed without huge upfront capital expenditures. HPS solutions are designed to integrate easily with other software solutions. Most importantly, clients who want to assure themselves that they are fully compliant with HIPAA EDI turn to HPS, as our solutions are fully compliant. HPS has also serves as consultant for clients who require HIPAA security solutions, including disaster recovery.
Regardless of size or specialty, medical practices across the country are challenged to capitalize on broader resources and greater efficiencies. At the same time, they are driven to attract new patients, elevate patient care and maintain control of their practice. For patients, there is a growing desire for an ability to make more informed healthcare choices based on current and meaningful provider information; especially in today’s ever-changing and often-confusing healthcare maze. Let’s face it, healthcare choices are perhaps some of the most important ones consumers make in their lifetime. FIND a DOCTOR helps consumers find the right healthcare solutions for their needs. Beyond that, FIND a DOCTOR also helps in establishing relationships between providers and patients and in enabling secure communications between both the parties.
‘Personal Health Record’ at its simplest and its best. CompleMed – Personal Health Record, a cloud powered solution, is an enormously valuable, secure, comprehensive, portable and instantly accessible medical record over a lifetime. CompleMed provides complete health information from all service providers and from own health updates. It provides complete control on viewing, sharing and protecting the health data. Manage your health better. Organize your doctor appointments. Set alerts and reminders.
HPS Novus is best suited for Self-insured and self-administered health plans. HPS Novus is a comprehensive software that incorporates Contribution Management including billing & receipt, Master Contract Maintenance, Eligibility & Cobra administration, Claim Processing (Medical, Hospital, Prescription Benefits, Vision, Dental, Hearing, etc.) and member and dependent administration. The system also has Pre-authorization module, Member service module, Utilization Module, Case Management and Disease Management capabilities. The system has capability to import electronic Claims and export electronic EOBs mandated under HIPAA. The system also has EDI capability for Eligibility query, Claim status query and Pre-authorization requests.
HPS Professional is cloud powered practice management software for Healthcare providers (physicians and allied health practitioners) and hospitals. They are ideally suited for Practices both large and small. The software integrates functions such as Appointment Scheduling, Encounter recording, Billing insurance companies and patients, compliant EDI for all transactions such as Claim submission and response in electronic format, Submit and receive Eligibility, Claim Status Queries and response and electronic Pre-authorization services. One of the distinguishing aspects of the software is its ability to auto post electronic EOB received from the payers and prompt for secondary insurance billing.
HPS Dental is a fully cloud powered application for use by Dental providers. It is available for use by Single Dental practice to large group practice and practices with multiple locations. The software integrates all functions of Provider office management including Appointment Scheduling, Encounter recording, Billing insurance companies and patients, HIPAA compliant EDI for all forms such as Claim submission and receiving electronic EOB, Submit and receive reply for Eligibility Queries and Claim Status Queries and submit and receive reply for Pre-authorization of services. One of the distinguishing aspects of the software is its ability to auto post electronic EOB received from the payers.
HPS Tandem is cloud powered software that is made available for providers (Physicians and Dentists) to prepare electronic transactions and post them to HPS Clearinghouse. The software enables practitioners who do not have EDI built-in to their Practice Management software to send and receive electronic transactions with payers. HPS also makes available the Tandem software as a Value Added Benefit to clients who use HPS Claim Processing system.
HPS Billing software is a secure application for doctors and practitioners to efficiently track all patient encounters and perform coordination of benefits. The billing software is very intuitive to use and helps avoid any billing errors. HPS Billing helps monitor attending physician coverage and offers capability to provide services for group practices, faculty practices and hospital outpatient services.
Embrace Electronic Health Record requirements and PMS with our intuitive, easy-to-learn, easy-to-customize and easy-to-use solutions. Simplify managing the demands of your practice as we back you up with passionate support.Our EHR solutions offer secure access to clinical information on the internet. They are very scalable and adapt well with your changing practice needs. Moreover, you can avoid large upfront capital expenditures and the ongoing maintenance costs & the pain associated with typical client-server offerings.
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HPS Clearinghouse is the portal for payers and Providers for transmission of EDI. HPS Clearinghouse receives electronic files (both HIPAA compliant and proprietary) and transmits between Providers of service and Payers. HPS Clearinghouse is fully compliant for Confidentiality and Security in addition to being certified for EDI. The clearinghouse has extensive validation process to validate 4010 and 5010 transaction formats.
This Web-based software permits comprehensive credentialing of the providers. It is available as ASP product. All requirements of provider credentialing are incorporated including document retention, primary verification, site visit report and Credentialing committee minutes. The system creates individual, secure portal for the Providers to verify their credentialing and re-credentialing information and modify as permitted by the Payer.
Employer Web Remittance
This is web-based software for employers to send the list of members every month to the Union or the Fund and remit the dues or contributions to the Fund. There is secure login available for each employer. The Fund can see all employer details. The database is synchronized with the HPS-TA.
HPS Member & Provide Online Portal
HPS can provide for Health Plans portal of entry for members to check their Eligibility and Claim status. HPS also provides forms on line for completion. This can include Member Registration form, Addition of a dependent etc.
HPS provides custom interfacing to other products, as desired by customers
We help funds achieve compliance of HIPAA regulations. We do that by providing means for Electronic Data Interchange (EDI) and guidance for privacy and security compliance.