I-TEL PRODUCTS

The I-TEL product suite is a comprehensive health benefit information system that is fully integrated across all functions to improve the quality and reduce the cost of healthcare delivery. A few of the advantages a fully-integrated system allows include the following:

iBenefits - Features

The iBenefits product provides a benefit administration system to efficiently manage enrollee benefits, payments to providers, and health plan operations. Its rule-driven design simplifies complex benefit structures and maximizes auto-adjudication rates. It supports the financial controls necessary to administer effective healthcare delivery. The iBenefits product: 

• Stores all enrollment data including demographics, eligibility dates, plan benefits, and provider networks
• Integrates authorizations from both iCare and iBenefits with claims to ensure claims are accurately processed based on the services authorized
• Allows automated authorization protocols by which authorization requests are automatically approved, denied, or pended for review
• Auto-adjudicates claims based on predefined, user-driven benefit packages, adjudication rules, and other insurance
• Tracks provider demographics, contracts, and pricing information for facilities, hospitals, physicians, pharmacy, and suppliers of durable medical equipment, home care, custodial, and transportation services
• Associates fee-for-service or capitation pricing arrangements at an individual provider or network level including support for Medicare fee schedule and re-pricing
• Provides premium billing and accounts receivable with supplemental riders, administrative and reinsurance fees, employer and employee dual receivables, and Life and AD&D premiums
• Produces electronic fund transfers or check drafts along with remittance advice and explanation of benefits reports for the payment of claims
• Automatically records all financial transactions for standard or custom reporting including cost centers and budgets and allows transactions to be interfaced with third-party financial applications

iCare - Features

The iCare product handles all aspects of patient care by tracking and documenting all medical management functions and interactions for and with patients and their caregivers.

Every organization has unique methods of recording data as well as unique workflows and reporting needs. To support this, the iCare application is designed to allow users to follow the workflows and record the data that are meaningful to them as they coordinate and manage the care of their patient population. The results are then easily documented in a comprehensive, user-driven, reporting package.

To support all types of medical management organizations and their associated requirements, iCare provides a flexible method to categorize cases as Utilization Management, Case Management, or Disease Management. This makes it easy to view and report on services, functions and activities and to know at a glance the volumes of the various types of cases.

A case provides the overall structure to link all activities and services together. The application offers a visual workflow for:

• Intakes
• Authorizations
• Pre-certifications
• Utilization Management
• Case Coordination/Management
• Disease Management
• Patient Care Status
• Survey and Assessment
• General Patient Information
• Problem, Goal and Intervention Tracking
• Treatment Planning
• Care Evaluation
• Staff Scheduling

iNet - Features

The iNet product provides secure, World Wide Web portals for members, groups and providers to access eligibility, authorization and claim related information. iNet also serves as a key component for sending and receiving data electronically in formats outlined by HIPAA ANSI X12 standards. The iNet product:

• Exchanges data with trading partners and regulatory agencies
• Allows on-site or remote claims data entry and correction
• Maps data stored on other systems to your Web site e.g., lab results and medical records
• Allows users to create precise, dynamic, database-driven Web presentations
• Easily changes or enhances data content on your Web pages without compromising the integrity of the data
• Provides user definition of how documents are presented e.g., Microsoft browser, wireless device, Acrobat document
• Produces dynamic and immediate data updates
• Allows information to be published on your Web site from any SQL-compliant source
• Supports browser technology that can detect common browser and wireless networks

iWarehouse - Features

The iWarehouse product serves as a robust data repository that has been optimized for analytical queries and reports. All data is populated immediately from iCare or iBenefits so that information is available on demand for reporting as a reliable decision support system. It provides a seamless integration with all systems including external sources. The iWarehouse product:

• Centralizes business rule information
• Produces complex reports from criteria selected by users with simple true/false statements
• Minimizes staff development time necessary for report creation
• Provides a straight-forward, consistent method for defining detailed healthcare concepts into a single true/false column
• Standardizes reporting for consistency across the enterprise
• Groups reports based on labels generated by complex criteria
• Consolidates disparate data from internal and external systems
• Efficient data movement uses minimum production system resources

iCommunicator - Features

The iCommunicator product automates the generation of correspondence for effective communication with member and provider communities. Letters are generated from templates with data imported from iCare or iBenefits allowing for user entry of information where appropriate. Multiple delivery methods are available, and correspondence is stored efficiently for quick retrieval. The iCommunicator product:

• Organizes communications processes within the organization
• Communicates efficiently and effectively with members, providers, and employer groups
• Creates document templates in a Microsoft Windows environment
• Automatically generates documents based on an event, eliminating human intervention
• Allows documents to be viewed from any authorized workstation in a PDF format
• Supports the transmission of documents via fax, e-mail, and hard copy print
• Archives document images permanently on the system