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Medicaid / Insurance Feature

The eRSP™ Medicaid / Insurance feature provides the essential tools for health care providers to perform medicaid and insurance based authorization services.

Calendar

  • Plan of Care (485) Forms
  • Support for ICD-9 Codes
  • Physician Order Forms
  • Multiple Payer Sources
  • Authorization Period Controls
  • Employee Credentials
  • UB04 & CMS 1500 Billing Forms
  • Payments Tracking
  • Authorization Status Reports

Electronic Claim Filing

The eRSP™ Medicaid Feature now has the capability of sending insurance claims electronically to both Medicaid and private insurance payers. This fully integrated feature is capable of filing Professional (1500) or Institutional (UB04) claims and tracking remittance and explanation of benefits (EOB) responses. This includes Primary and Secondary claims and a claim alteration/resubmission process for errors and EOB denials.
  • Professional (1500) and Institutional (UB04) Claims
  • Primary and Secondary Claims
  • Claim Alteration and Resubmissions
  • Disposition Reason Codes
  • Claim Filing Status Notifications

GatewayEDI

Kaleida Systems has partnered with GatewayEDI to process electronic claims to all Medicaid and Private Insurance companies in every state. Payer sources that do not support electronic claims are automatically dropped to paper forms.

Payments

The eRSP™ Medicaid Feature also includes a Payments Tracking utility. This feature enables you to perform the following as a supplement to your accounts receivable.
  • Post invoice payments per service date
  • Post partial line item payments
  • Post notes and reason codes for short payments
  • Tracking invoice payment status
  • View invoice status reports

 

With the eRSP™ medicaid / insurance feature now the fully integrated with the already robust calendar, you have the ability to easily manage large volumes of authorization services.

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