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KMR Claims Processing Manager is a state-of-the-art, fully integrated, customizable claims processing solution for TPAs, Self Insured and Claims Administrators. Our system includes a Comprehensive Medical & Dental Reimbursement module, allows for electronic claims, integrates with Document Imaging systems, has the ability for Debit Card Processing and is totally HIPAA compliant. 

KMR's Claims Processing Manager Features:

  • Member/Dependent Eligibility Checking
  • Multiple Plan Coverage Caps & Limitations
  • CPT Reasonable & Customary Pricing
  • Special Provider Pricing
  • Procedure Grouping
  • Coordination of Benefits, Co-Pays & Deductibles
  • Scanning & Image Management Capabilities
  • Claims Processing Including Ability to Scan, Receive via EDI or Manual Entry
  • Capability to Process Claims Through Our PPO Router System For Electronic Re-pricing
  • Document Image Management System Eliminating Need to Store Paper Claim Forms
  • Easy Retrieval Process Including Ability to Re-print Claim Form
  • Check & EOB printing
  • Voucher Printing Including Explanation of Claim Denial
  • Positive Pay & Direct Deposit Capabilities
  • Comprehensive Claims History Display
  • Various reports including Claims Paid by Provider, CPT, Procedure
  • Surcharge & Assessment Check Printing & Reporting
  • Adjuster Analysis Reporting
  • Actuarial Reporting
  • Debit Card Processing
  • 1099's & IRS Magnetic Media Filing
  • Web Inquiry Capabilities
  • Check Reconciliation System Including Ability To Post Cleared Checks From Bank
  • Totally HIPAA Compliant

Contact us to learn more about how we can help you manage your Claims Processing requirements more effectively and efficiently.
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