Eldorado's Alliance With PMCS Enables Payers & Providers To Enhance Benefits & Savings
Seamless technology integration enables electronic transmission of "out of network" healthcare claims to PMCS for claims negotiation and settlement
Eldorado Computing, Inc. (ELDORADO), an MphasiS Company anda leading provider of health benefit and claims management platforms, recently announced the integration of its Javelina and HEALTHpac platforms with Preferred Medical Claim Solutions' (PMCS) Preferred Data Interchange (PDI) system. This integration will provide Eldorado's health plan, third party administrator (TPA), insurance carrier, self-insured clients and their members the ability to reduce the cost of "out of network" healthcare services.
"Traditionally, approximately 10-20 percent of medical claim dollars fall outside the primary care network," stated Paul F. Caliendo, President and Chief Executive Officer of PMCS. The integration with Javelina, Eldorado's innovative, next generation, browser-based platform, as well as its HEALTHpac system, automatically identifies and then sends "out of network" claims to PMCS during the adjudication process. "All upfront costs have been absorbed by PMCS and Eldorado. In 2009 PMCS' success rate exceeded 72% of the claim dollars we received, and we reduced our clients' allowable billed charges by over 15%," continued Mr. Caliendo.
PMCS' Advance Funded Provider (AFP) program has the built in technology to permit PMCS to process, negotiate and remit the provider settlement on a timely basis, enabling Eldorado's clients to enhance their cost containment capabilities without altering their funding cycles. The program can also be instrumental in improving customer satisfaction and increasing member loyalty.
"We are pleased to offer our clients added cost containment value through our technology integration and alliance with PMCS," stated Tom Castleberry, Vice Chairman of ELDORADO.
About PMCS
Based in Scottsdale, AZ, Preferred Medical Claim Solutions (PMCS) assists all Payers, including insurance carriers, self-funded employers, patients, associations and members in reducing their cost of healthcare. PMCS partners with Third Party Administrators (TPAs), Administrative Services Only (ASOs) and Health Maintenance Organizations (HMOs) in the prompt settlement of medical bills with medical providers on a national basis. By utilizing our state-of-the-art custom electronic data interchanges and our direct provider agreements, PMCS' services are proven to efficiently reduce paperwork, eliminate disputes and reduce the cost of healthcare.
About ELDORADO
Based in Phoenix, Ariz., Eldorado (Eldorado Computing, Inc.) specializes in health insurance application development, business process outsourcing (BPO) services, IT engineering and operational consulting. The company serves the full spectrum of organizations nationally and internationally engaged in managing health benefit plans including third party administrators (TPAs), health plans, employers and self-insured organizations. Together, Eldorado customers manage 5 million lives and handle 35 million claims annually. For more information, contact 602.604.3100 or visit www.eldoinc.com and www.eldocomp.com.
* The legal entity remains unchanged as Eldorado Computing, Inc. Eldorado is a wholly owned subsidiary of MphasiS, an HPcompany.
SOURCE: Eldorado Computing, Inc.