Ecura ProviderConnect
e-business enables you to conduct business-to-business transactions using the Internet. While e-business is common to many industries (e.g. business-to-business ordering and funds transfers, or exchanges of stock between investment banks and trading houses), healthcare has been slow to transition business processes (like authorizations requests from providers and claims submissions) to the Internet. In fact, only 30 percent of the health plans in the country allow providers to submit authorizations over the Internet.
What is eCura™ ProviderConnect?
eCura™ ProviderConnect is an e-business extension to the eCura™ Information System. With ProviderConnect, you can distinguish yourself as one of the few health plans that uses the Internet to conduct business transactions with your providers. By providing an alternative path for exchanging membership, authorization, clinical, and claims data, ProviderConnect allows a free flow of information between you and your providers without the bottleneck of telephone or paper-based communication. ProviderConnect is designed to improve your business relationships, establish stronger lines of communication and reduce overall costs.
How is eCura™ ProviderConnect used?
eCura™ ProviderConnect allows your providers to conduct the following e-business transactions with you over the Internet:
- Query your membership database to determine whether a patient is eligible for services
- Review members' benefit plans to establish available funding resources for patients
- Request authorizations to provide services to your members
- Check on the status of authorization requests that have been submitted electronically
- Submit claims (individually or in batches) requesting reimbursement for services rendered
Talking Tech: How does ProviderConnect Work?
eCura™ ProviderConnect relies on the following technology:
- Microsoft® Internet Information Server (IIS)
- Internet devices with modems, a web browser (e.g., Internet Explorer) and a connection to the Internet
Your providers will connect to your eCura™ Information System through the Internet Information Server (IIS). eCura™ ProviderConnect relies on Microsoft's® Component Object Model (COM). COM is Microsoft's standard for inter-application communication. COM allows your providers to use ProviderConnect to send information directly to your eCura™ Information System, as well as retrieve information from it.
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