Expand the base functionality of SIMS Claims™ and further streamline your workflow with these additional modules and interfaces.
Modules & Connectors
We provide a number pre-defined interfaces to 3rd party systems and additional software modules to round out the unique functionality your company may require to process claims.
Agent/Insured Portal Module
Provide your agents or insureds the ability to submit their claims on line, review reports such as Loss Runs or Plans of Action, and enable agents to self-subscribe to an automatic report to be e-mailed to them on a scheduled time frame.
Shorten the turn-time of critical documents requiring a wet signature by presenting documents for electronic signature via AssureSign.
Check Issuance Module
Streamline your check issuance process by issuing checks on secure laser paper, combining payments from one or more claims onto a single vendor check, and printing EOR/EOB's on the same page as the check.
Claim Import Connector
This interface is used to import claims submitted electronically from your claim intake provider. The same business rules used when creating new claims within SIMS Claims™ (coverage verification, auto-adjudication, etc.) are applied to this interface.
SIMS Insight Module
SIMS Insight, the advanced business intelligence module of SIMS Claims, delivers the information you needâ€”with greater speed and agilityâ€”to improve claim results, reduce program costs, and minimize future risk.
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SIMS Claims™ provides various options for submitting CMS/Medicare-Medicaid data including interfaces with MRRS, ISO, and Gould and Lamb.
For large insureds or self insured accounts, this interface can save on the key entry of personnel data by automatically importing employee wage and demographic information from human resource systems after entry of either a social security or employee number.
ISO Claim Search Connector®
Claims transmitted from SIMS Claims™ to the ISO ClaimSearch® are processed and matched against millions of other claims in the database. If the system finds a match, a report is returned and stored in SIMS Claims™ to help you identify patterns that may indicate fraudulent or suspicious activity as well as duplicate coverage.
Medical Bill Review Connector
The Medical Bill Review Connector interface is used to submit claim and vendor information to your bill review company and import medical paymentsâ€”including EOB informationâ€”into SIMS Claimsâ„¢. Once imported, all medical information is easily accessible in the payment and reporting modules.
Mitchell Collision Repair Connector
Streamline interaction with collision repair centers by sending a repair assignment to a repair shop and receiving back estimates and reports about the repair.
Payables-Check Issuance Connector
This interface is used when checks are not printed within SIMS Claims™. In that case, it exports approved payments to your accounts payable or check printing system. Once the checks are printed in the external system, SIMS Claims™ imports the check numbers and check dates and matches them with the corresponding payments.
SIMS Claims™ includes a number of payment interfaces to allow you to import electronic payments into the system.
Streamline your workflow by electronically sending Pharmacy Card eligibility data to your Pharmacy Benefit Manager (PBM).
This interface is used to import policy information into SIMS Claims™ to verify coverage and include policy information in Loss Run and other reports.
Positive Pay Bank Connector
This interface is used to reduce check fraud and to improve internal controls. This interface communicates with your bank electronically, submitting check data (check number, payee, amount, etc.) from SIMS Claims™ and receiving back into SIMS Claims™ the cleared dates and check status.
Our interfaces can be modified and expanded based on the client's requests and are ready to read and write to a variety of formats including XML, flat files, Access, Excel, and a number of OLE DB providers.