TPA Claims Management Software

MedinyX is a complete TPA (Third Party Administrator) solution for claims management system. It is designed to enable automated health benefits administration and claim adjudication. An improved user experience, improved patient care standards, significantly reduced administrative costs, and much more can all be achieved while adhering to all regulatory standards.

Our product can easily adapt to any existing infrastructure. The software can be customized with any third-party application to meet the market's ever-changing demands.

MedinyX TPA Claims Management System offers influential advantages to enhance the velocity and effectiveness of claims preparation and settlements further escalating client administration and fulfillment levels.

MedinyX TPA Platform Modules

Accounts / Finance

Payments
Deposit
Advance
e-Approvals

Admin

User Rights
Office & User Configuration
Currency & Country Configuration
Admin Eye & Email Rights

Credit Control

Party Ledger
Days Interval Outstanding
Payment Settlement
Followups & Email reminder

Client Portal

Portal for Hospital
Portal for Customer
Portal for Insurance Company
Portal for Assistance Company

Claims Payment

Claim Adjudication
Claims Audit & Investigation
Running Claims / Pending Claims
Claim Payment Verification
Closed Claims

Claim Operations

Claims Itntimation
Claim Dashboard
Claim Auditing
Documents Verification and Uploads
Claim Verification and Claim Registration

Invoicing / Billing

Invoicing to Insurers
Invoicing Approval
Multiple Currency
Provider Billing

Preferred Providers

Preferred Providers
Pre Agreed pricing
Discount and Negotiation

Policy Management / Member Enrollment

Policy/Plans Configuration
Policy/Plans Benefits & Limits
Checklist for Policy Benefits
Bulk Enrollment - Excel
API Enrollment - XML, API

Benefits for Health Insurance Company

Multiple currency management

Claim dashboard

Automated alerts and notification

Tailored workflow as per your requirements

Reduce the claim cycle time

Improve productivity and efficiency with Claim process automation

Platform Screenshots

ICD-10 Diagnosis

Provider Invoice

MCC Invoice Details

Claims Dashboard

Some of the key features of MedinyX TPA system

Claim notification and automotive response in minimum time to the client.
Claim Registration and Verfication
Claim management system holds the ability to remind the urgent and pending claims on the group and individuals.
Full provider network database with integrated map service.
Handling of claims requests.
Insurance claim management software have the ability to store large number of data related to the claim whether medical, financial or network related.
All communications - documents and logs stored directly on the related claim.
Ability to share the files with individuals and groups at the same time.
Has real time currency exchange features.
Templates for all outgoing communications.
Allows files to transfer and share with different dept. for billing, networking and Auditing purpose.
Claim management system's ability to share the Medical information with medical dept. and to avail their authorization and recommendation online on the critical medical cases.
Online authorization features.