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.

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.


Seamless Integration of Multiple Lines of Business

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.


Expert management of all key components of your business

  • Claim and encounter processing
  • Managed care administration
  • Workers' compensation administration
  • Policy/Benefit administration with support for eligibility, billing, collections and commissions
HIPAA Compliance

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.


Interactive "Web" and "Voice-Enabled" Benefits Communication

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.


Fully integrated, advanced technologies for added functionality and advanced productivity
Automatic claim adjudication
Electronic Data Interchange (EDI)
Electronic claim workflow
Claim processing/pre-processing
Automatic claim coding
Optical imaging / IOCR
MICR laser check / EOB encoding
Standard/custom report generation
Letter generation

Managed Care
Clinical editing and auditing
Provider network management
Provider capitation management
Pre-Authorization, UR, UM,
and physician referrals
Point of Service (POS)
Primary Care Physician profiling and credentialing
Case management

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