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X12 Medical Claims ProcessingClaims Manager

Claims Manager handles details about X12 Claims message transactions.

Spectre has been working in EDI using X12 since the mid-1990s.  When the government mandated medical claims be processed electronically, we have much of the infrastructure and resources to process these transactions already in place.

Our claims manager is the front end for several process components.   The data for out going messages such as 837 claims and 270 eligibiliy are sourced directly from client systems and build with routing information from our setup.   We can route data through any number of transports and easily switch routes as payers and transports (often) change.

Our Message Processor with validate batch and claim level acceptance and translate message codes into descriptions to help correct batch or claim data issues and then quickly reprocess and resubmit the claims.   It also permits application of remitance advice messages and payments.

Spectre provides complete system from basic manual entry in our web based application to data storage in our our large scale SQL database.  Once installed, our system automatically processes claims and notified your staff of issues and corrective actions required to sucessfully re-process claims.

Our Mission

Listen to what is needed.  Design for exactly that, while looking for places with room to add scale for growth.   Never assume it will always work, so add processes for smoothly handling faults quickly.

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