(From eSchool News September 2005 print edition)
4GL School Solutions Inc. has released the ENCORE! Claims Tracker module, designed to convert student encounter data into electronic claims that can be transmitted automatically to processing agencies for reimbursement.
Part of 4GL’s ENCORE! suite of solutions for special-education data management, Claims Tracker enables districts to use state Health Insurance Portability and Accountability Act (HIPAA) record formats to keep student Medicaid eligibility information, prepare and submit Medicaid reimbursement claims, and process claims remittance advice quickly and easily. Claims Tracker also automatically applies the correct state rates, codes, and rules when generating claims, 4GL says.
The software produces financial and management reports for administrators, identifies denied claims that warrant further investigation, and allows users to create an audit trail that can be used to defend revenue generated from the billed claims. 4GL says its ENCORE! Claims Tracker meets standard reporting requirements, as well as HIPAA guidelines for the confidentiality of student information.