ClaimExchange (CE) is designed as five distinct components.

CE Server. CE Server provides unlimited flexibility in handling and scheduling incoming and outgoing EDI traffic. It downloads EDI files from Trading Partners, decrypts these files, loads them into the CE Database, re-bundles claims, exchanges claims with repricing vendors, maps and sends them to your batch adjudication system, receives status files back from batch adjudication, sends an electronic remittance advice and allows real time inquiry into claim status and eligibility. Any other custom task that your organization requires can be easily integrated into the CE Server framework.

CE Server maintains an extensive audit trail of all actions performed. It sends a wide variety of customizable alerts if something unexpected happens. It is also an entry point for any reports that need to be scheduled on a nightly basis.

CE Admin. CE Admin is used to configure tasks controlling data files and parameters. These tasks set up trading partners, directory structures, system parameters and other options.

CE Manager. CE Manager is a browser-based application designed to run over an organization’s intranet. It features a customizable Today Screen that can display all of the information an EDI-Coordinator or Claims Manager would want to view on a daily basis. CE Manager tracks open issues and compares actual events against expected events.

CE Reports. CE Reports is an browser-based application providing for inquiry, viewing and printing of EDI and rapid data entry submissions (from CE Workstation), claims and reporting.

CE Workstation. CE Workstation is a unique feature of ClaimExchange that allows a single entrance for all claims, whether received electronically or on paper. HCFA 1500 forms, Superbills, Dental forms and UB92 forms can be rapidly data entered through ClaimExchange. Once entered, these claims become a submission as if they had been received electronically. Current CE Workstation users average over 400 claims per day.