System Information:

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System Overview
EnCore health benefit management solutions are delivered by an array of highly efficient and productive applications to manage and administer health, dental, vision and prescription drug benefits. These include enrollment, eligibility, billing, electronic claims, auto-adjudication, clinical editing, medical management, customer service, ad hoc reporting, standard reporting and a host of additional processing capabilities functioning in compliance with HIPAA mandated transaction code sets in a secure environment.


 

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SaaS Services
EnCore SaaS Services deliver automated Claims Management solutions wherever and whenever you need them. Reduced costs, solid reliability and secure HIPAA compliant transactions make an EnCore SaaS solution particularly attractive. Overhead costs associated with on-site solutions are reduced to a minimum. Let EnCore host the system for you in our data center while you access it remotely. You no longer need to worry about backing up your system, maintenance or disaster recovery of the server.


 

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Billing and Administration
Designed to function as a sub-system of EnCore Claims Management or as a stand-alone solution, EnCore Billing and Administration simplifies management of health, dental, vision, life and disability benefits billing and administration.


 

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Claims Management
EnCore’s automated Claims Management solutions provide a higher level of productivity and accuracy. Tightly integrated EnCore applications and specialized third-party plug-in solutions work together to process your hospital, medical, dental, vision and pharmacy claims efficiently in complete compliance with HIPAA mandates.


 

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Medical Management
Enter and track authorizations, manage a “case” and perform concurrent review with EnCore Medical Management solutions. Medical Management processes are integrated with the EnCore claims management system to alert claims and customer service personnel to newly filed authorizations and/or member cases. This module is also available as a stand alone application. EnCore Medical Management solutions bring new levels of efficiency and productivity to your case management team thereby enabling them to deliver superior customer service.


 

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Dental Management
Optimized to boost efficiency and productivity, EnCore Dental Management consists of a flexible and powerful array of integrated processing, tracking and monitoring capabilities. It is the ideal solution for your Dental benefit and claims management tasks.


 

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Reporting
Transaction data generated by EnCore can be a rich source of useful information. EnCore’s user friendly ad hoc reporting tools help you leverage your data to exploit cost reducing opportunities, make better business decisions and provide better customer service.


 




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