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FACTS® Services, Inc. (FSI) was founded for the purpose of designing and implementing fully automated and integrated software and hardware solutions for use by healthcare payer organizations. FSI is a company dedicated to making the job of the healthcare administrator "easier" and "more productive." Our philosophy is based on a direct appreciation for the effort and challenge of creating high performance and sophisticated, user-friendly tools. This philosophy has served as the common factor in the development of the FACTS® product line.
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With FSI, you can meet all your health claims management needs from a single company - from software systems to hardware options to full-service training, support, and consulting. FACTS® is 100% responsive to your mission critical business needs - providing you with everything you need and expect in a health claims management system.
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Seamless Integration of Multiple Lines of Business
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The FACTS® family of products supports multiple lines of business within a single information system: Health, Indemnity, TPA, PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, Section 125-Integrated Flexible Benefits, and Workers' Compensation with Integrated Managed Care for 24-hour coverage.
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Expert management of all key components of your business
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- Claim and encounter processing
- Managed care administration
- Workers' compensation administration
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Policy/Benefit administration with support for eligibility, billing, collections and commissions
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HIPAA Compliance
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From the inception of HIPAA, the FACTS® system infrastructure has been based on HIPAA-compliant solutions. FACTS® is fully committed to ensuring a clear and easy path to HIPAA readiness - well ahead of the federally mandated compliance deadlines.
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Interactive "Web" and "Voice-Enabled" Benefits Communication
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FACTS® fully integrated, interactive Internet and voice-based systems empower healthcare administrators and professionals with 24 x 7 access to claims and benefit information, and real-time transactions such as EDI claim uploads, through the Internet.
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Fully integrated, advanced technologies for added functionality and advanced productivity
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Automatic claim adjudication
Electronic Data Interchange (EDI)
Electronic claim workflow
Claim processing/pre-processing
Automatic claim coding
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Optical imaging / IOCR
MICR laser check / EOB encoding
Standard/custom report generation
Letter generation
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Managed Care
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Clinical editing and auditing
Provider network management
Provider capitation management
Pre-Authorization, UR, UM,
and physician referrals
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Point of Service (POS)
Primary Care Physician profiling and credentialing
Case management
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