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Electronic Claims Submission System  

 Product description

ECSS is a single-user product that can run on almost any PC equipped with Windows*, an Internet connection, and a printer. Using ECSS you can create prescription drug claims quickly and easily using your PC keyboard and screen, and transmit them using an internet connection. Claims are adjudicated and responses are retuned to your screen within a matter of seconds. An audit page showing all claim and response information can be printed and accepted claims may be saved on your hard disk to be used for reversals or future refills. ECSS is the ideal replacement for paper claims or a POS terminal giving you the instant adjudication you need at a fraction of the cost of a full practice management system.

* Windows is a trademark of Microsoft Corporation

 System Requirements:

System:
PC running Microsoft Windows 7 or higher *
Processor:
1ghz or higher (will run at lower speeds)
Memory:
512 meg or higher
Disk space:
30 Meg at installation then varies with options
Printer:
Ink Jet or Laser recommeded
Comm:
An Internet connection is required

This product is distributed on CD


 Claim Switches

NCPDP claims are usually transmitted through a "Switch". The switch acts as a router to assure that the millions of claims being submitted by providers reach the correct payers and the responses from the payers make it back to the originating provider. The major national switches used with DayTech products are RelayHealth (NDC) and Change Healthcare (Envoy).  

DayTech software is certified with both RelayHealth  and Change Healthcare for the creation and transmission of prescription drug claims in all of the commonly used NCPDP formats up to and including Version D.0.


 NCPDP versions

ECSS currently supports the following NCPDP formats:

Version D.0 variable (all transaction types)
Version 5.1 variable (all transaction types)
Version 3.2 variable

 Transmission methods

ECSS can transmit claims over a secure, encrypted internet connection. A dialup modem may also be used but is not recommended.

 Insurance plans supported

ECSS comes with setup information for over 2,000 commercial and State Medicaid insurance plans that accept prescription drug claims in NCPDP format. This list is searchable by plan name, BIN, or processor control number. Once a plan is selected it can be activated with a mouse-click and a few keystrokes. The plan is installed with its required fields already set. The user may fine-tune these fields as required to match their particular submission requirements.

 Single or batched claims

Traditionally, POS claims are created and sent one-at-a-time in a manner that is similar to credit card authorization processing. Using ECSS you may also create batches of claims and transmit them automatically. Responses are still received in real-time and are saved to disk. They may be printed or displayed on the screen. Batches may contain claims for different patients and plans. Users can create and delete their own batches as necessary.

 Automated batch processing

Batches of claims may be transmitted in unattended mode allowing the user to leave the computer while claims are being processed.

 Report Engine

The Report Engine is a feature of ECSS that allows you to produce custom reports from a queriable database of information collected about each transaction. Refer to the Report Engine product description for details.  

 Local Reports

ECSS also supports several local printing and report options that can be customized to your operation. It can print a full page for each transmitted claim which may then be placed in the patient's file. For pharmacies using their printer for special forms, ECSS can run printerless, saving the last 1000 responses on disk so that they may be reviewed on screen and printed later if necessary. Additionally, a printed audit report may be produced at any time listing every paid claim. The report is organized by insurance plan with totals.

 Claim images

The system may be set to save the latest image of each paid claim to disk. These claims are saved under the patient's ID and may be recalled at any time to reverse the claim or create refills. They may also be used as templates to create new claims. This feature virtually eliminates data entry on reversals and refills. It also drastically reduces the data entry required on new claims.

 Point & Click design

Using the mouse and/or keyboard you can quickly navigate between screens and fields.

 Help system

Help is always a mouse-click away! In addition to the printed Quick Start Guide, a PDF version is always available from the program bar. You can also get help right down to the individual field level during claims entry explaining the purpose of the field and the standard NCPDP values that may be assigned to it.

 Privacy and security

ECSS supports User ID's and passwords. It also allows you to select access privileges for each user based on their need to know.