| Apex Data Systems' exceptionally flexible software products are excellent tools for companies offering a wide array of supplemental coverages to their insureds. Our total solution packages include support for many plans often overlooked. Whether offered as supplemental group products, voluntary employee benefits, or individual contracts, we are able to support your needs for critical illness policy administration and claims adjudication. Our comprehensive features give you flexibility and control in the management of your programs, and excellent time-to-market results for new start-ups.
Administration Capabilities
With special consideration given to worksite sales and payroll deduction options, our administration software delivers total support for enrollment, policy/certificate issue, billing, collection, premium accounting, agent commissions, and detailed reporting. Administration of Critical Illness policies can be implemented in conjunction with other coverage types such as life, health, or long term care products, or as a stand-alone package. Advantages offered by Apex Data Systems' Critical Illness software include: A dynamic enrollment structure that allows for base and rider coverages with separate inception and termination dates, premium amounts, and payment transaction records. Flexible billing features including individual direct bill, individual list bill (for payroll deduction), and group bill capabilities. Linking of multiple family members on a single bill is another possibility. Electronic Funds Transfer features that allow for fully automated Pre-Authorized Checking, bank drafts, and credit cards. Rating load and discount factors that are available for substandard and preferred business so you can appropriately handle impaired risk classifications. Notepad functions that even allow medical history to be maintained for declined applicants for comparison against future application requests. Claims Capabilities
Our consolidated claims software allows for a seamless tie between claims eligibility and adjudication. All features of Apex Data Systems' claims management system are available when processing Critical Illness benefits. Global features such as online eligibility verification, pending and correspondence modules, online adjudication by user-defined plan tables, issuance of multiple payments to the insured or multiple payees, detailed claims history, actuarial and lag studies, premium/claims analyses, and other reports are all part of our total solution. Features especially valuable for Critical Illness benefits processing include:
Acceptance of the initial notification of claim with documentation to the file. A correspondence system allowing you the flexibility to establish letters and automatic follow-ups based on user-defined parameters. Capture of date of diagnosis or treatment with maintenance of per-submittal and episodic claims data. Capture of cause, ICD diagnostic, claim type, and other pertinent, user-definable codes. Attending physician information including full name and address for correspondence purposes. Free-form claim comments for diary or other purposes. User-defined claims plan setup allowing for adjudication of a lump sum payment upon diagnosis, incremental payments, or indemnity-type of reimbursements. Definitions of qualifying illnesses as part of plan setup. | |
