Eligibility Maintenance & Reconciliation

Data Transfers

Our in-house IT staff can custom design data extracts and imports to make new case transition seamless. Likewise, we will make plan data available to other business partners, such as the prescription benefit manager or ancillary line providers so multiple enrollments are unnecessary.



Sample invoice from NAA, a health plan administrator and tpa in tennessee offering self funded health plans and claim administration to self insure.

Click to see a sample of a billing screen


List of reports from NAA, a third party administrator offering self funded health plans, claims administration and employer healthcare.

Click to see a sample of the reports

NetAccess

Your connection to live, real-time information about your health care plan.

NetAccess provides our plan administrators with the on-line tool to access billing invoices and detailed billing statements. Downloadable and printable versions of the bills and specific participant information are available.

Claims related information is available to the plan administrator at the click of a mouse. Processed claims may be listed by date of service and Explanations of Benefits may also be viewed.

Current eligibility information can be accessed on a group basis or on a participant-specific basis, as well as coverage history and coordination of benefits information.

 


Sample benefits sheet from NAA's enrollment wizard - NAA-LP is a third party administrator offering claims administration and self funded health plans for employers who want to self insure.

Click to see a sample of an enrollment screen

CEW

Comprehensive Enrollment Wizard

Provides plan holders and participants with electronic enrollment, termination and coverage change capability, as well as enrollment reports and individual benefit statements. CEW also serves as census management software for the planholder.

Despite our advanced on-line services, some clients still prefer hard copy. We will gladly accept paper enrollments and will even customize forms for your specific group plan.

 

 

 


Eligibility Reconciliation

A plan eligibility specialist is assigned to each client. This individual will assist in eligibility reconciliation and ongoing eligibility maintenance.


Verification of Benefits

Plan holders, employees and providers can immediately receive a summary Verification of Benefits via the NetAccess system, our Interactive Voice Response system and our automatic fax-back system.