When Was The Claim Received? Has It Been Paid?

FlexVP Managed Care Applications

ISG has created a series of IVR applications that can be selectively integrated to provide custom call handling solutions for health care organizations.


Claims Application

This application allows members and providers to retrieve basic claim information over the phone without tying up your staff. The claims application uses a data interface to access real-time claims information residing on the MCO's central computer system.

Using data entered in by the caller (provider ID, member ID, the date of service or a claim number) claims are retrieved from the MCO's database. The caller can then review each individual matching claim over the phone, or have a summary of each claim faxed to them.

The claims application can provide information on the following frequently asked claim questions:

Other information that can be given to the caller includes:
  • When was the claim processed?
  • How much was paid?
  • When was the paid date?
  • Is the claim still pending?
  • Fax information to what number?

Voice Response Overview

FlexVP IVR Platform

FlexVP allows callers to automatically access healthcare and member information using a touch-tone telephone. Applications include verification of member eligibility, obtaining member benefits information, accessing status of claims information, and authorizations / referral entry and review.

This information is obtained through an interface to the managed care organization's claim system. ISG has integrated the FlexVP interactive voice response (IVR) system with healthcare claims systems offered by: DST Health Solutions, Perot Systems, Erisco Facets, Ika Systems, and OAO Healthcare.

FlexVP can access network or LAN databases including Microsoft SQL, Oracle, MySQL, etc. using a data view, stored procedure or web service.

For legacy products,  FlexVP can connect to mini or mainframe computer using 5250, 3270, VT100 or other terminal emulation.


FlexVP Benefits

  • Information available 24 hours a day, 7 days a week
  • Faster service to providers and members
  • Decreased wait times and abandonment rates
  • Increase call capacity without adding service reps
  • Customer defined levels of login and password security
  • On-line, real-time system status checks and reporting
  • Provide consistent information to insure HIPAA compliance

2009 Insurance Systems Group, Inc. P.O. Box 50387 Raleigh, NC 27650