CLAIMS AND BENEFITS ADMINISTRATION SOFTWARE
Your Claims Solution for Efficiency And Cost Savings
MediClaims is WLT’s Claims and Benefits Management Solution: technology that is cost-effective, straightforward, and efficient. Claims that are processed quickly, easily, and accurately, with complete benefit management capabilities.
MediClaims is a user-friendly native Windows® application partnered with Oracle®, one of the most powerful databases available. This system offers not only the versatility to meet the different needs of each user, but also the adaptability to meet ever-changing industry trends.
Flexible Benefits and Claims
A robust benefit management solution.
MediClaims’ administration and processing capabilities encompass a range of benefit and claim types, from standard Medical, Dental, Vision, and Prescription Drug, to FSA, HSA, HRA, COBRA, Disability, and HMO Capitation as well as MEC and level funded plans.
Sophisticated and Powerful Databases
Advanced systems and technologies at your fingertips.
No plan can work efficiently without support from reliable information systems. WLT always works with the most advanced technologies, providing you with the most sophisticated and flexible systems available today.
MediClaims is a user-friendly native Windows® application partnered with Oracle®, one of the most powerful databases available.
MediClaims is our flagship solution for:
Claims Management
Claims processing for medical, dental, vision, and prescription drug plans
Claim precertification, referral, and case management functionality
Capitation maintenance and payment processing
Administration & Billing
Consumer-driven healthcare benefits administration, including FSA, HRA, & HSA
COBRA administration
Eligibility administration
Disability processing for both short and long-term benefits
Premium billing and agent commissions
Easily configurable system security
Data Management
Customer service contact management
An extensive library of standard and custom reports
HIPAA-compliant EDI 5010 and legacy 4010 transactions
Discover more
The MediClaims
Advantage
To fully see how our system can help you save time, reduce cost, and increase your operation’s compliance, please share your contact information and we will schedule a confidential demo session.
Claims and benefits software powered by capabilities
Claims Processing & Editing
Claims Processing & Editing
WLT’s user-friendly interface and processes allow claims to be processed quickly, accurately, and easily in real-time.
MediClaims’ processing and editing capabilities encompass a range of claim functions from:
- Standard Medical, Dental, Vision, and Prescription Drugs
- FSA
- HSA
- HRA
- Disability
- HMO Capitation
- Medicare Supplement
Administration & Billing
Administration & Billing
The MediClaims system’s intuitive user interface simplifies the administrative duties of the Benefit Administrator. Precertification, Eligibility, PPO Administration, Letter Writing, and Call Tracking are just a few of the many features designed to save you time and money. WLT’s flexible plan design allows you to have multiple plan options at the group and individual levels.
The Premium Billing & Agent Commissions portion of our system allows you to effortlessly bill for premiums and collect payments. Billing can be performed at the group, location, or even the individual level. And to top it off, distributing commissions for collected premiums is also made easy.
Compliance & Reporting
Compliance & Reporting
WLT understands that a critical aspect of a benefits administrator is compliance with various federal laws. WLT continuously monitors evolving federal requirements to determine how to help automate the required processes through our system’s functions.
Some of our compliance features are:
- NSA & TiC Compliant
- COBRA Qualifying Event Notification Letters
- PCORI and Transitional Reporting for ACA
- 1094-C & 1095-C Forms and Electronic Filing
- HIPAA EDI Compliance
- 835 CAS Reason Code Mapping
- 835 RARC Code Mapping
- 1099 Forms and Electronic Filing
- W-2 Forms and Electronic Filing
Consumer-Driven Healthcare
Consumer-Driven Healthcare
The popularity of consumer-driven healthcare plans has been on the rise in recent years. WLT’s MediClaims system can easily administer these plans and incorporate benefits with your health plan.
Some of the features of our Consumer-Driven Healthcare (CDHC) module include:
- Flexible Spending Accounts (FSA)
- Health Reimbursement Arrangements (HRA)
- Health Savings Accounts (HSA)
- Automatic FSA payments for health plan out-of-pocket expenses
- Integrated HRA benefits in your existing health plans
- Administrative reporting and member statements that are specific to your FSA,
HSA, and HRA plans
In addition to the above features, an integrated benefits card is available. The WLT MediCard Benefits Card can be used by your members to settle point-of-service transactions directly from their available CDHC funds.
Security
Security
All your data is safely stored in the award-winning Oracle database and is exportable in virtually every format (Excel®, Word®, PDF, etc.). The databases are encrypted with advanced techniques to ensure your data’s protection, and MediClaims adds additional layers of security by customizing access to programs through multiple roles in the company. System security reports help authorized personnel identify every program a user can access, ensuring your configuration has the desired results.
Web Portals
Web Portals
Our Web Portals grant users an innovative, streamlined approach to benefit and claims management, while continuing the tradition of excellence our Clients have come to expect.
Full integration with the core WLT systems provides instant data access, allowing for more dynamic automation of Enrollment, Member Registration, Call Tracking, and much more.