SIMPAL Health and Welfare administration
EDI, Auto-Adjudication, ICD-10, Medical, Hospital and Dental claim adjudication.

Accidents

No one likes an accident – but they can be made easy to search, setup, and adjudicate, with SIMPAL.
Accidents
Dental Claims

Tooth number, surface, prosthesis – SIMPAL leaves your dental claims feeling office visit fresh
Dental Claims
Medical Claims

ICD-10, ISO-5010, HCFA and UB’s, all driven by a world-class EDI and Auto-Adjudication engine.
Medical Claims

SIMPAL Health and Welfare administration enables your organization to:

  • Set up multiple Health Plans with ease.
  • Receive Profesional and Institutional Health claims electronically with our EDI 835 and 837 modules and parsers.
  • Auto-Detect duplicate billing, for not just one type of claim.we have your back for multiple types of claims, ever seen patient dental history on a chart?
  • Process and pay Profesional, Institutional and Dental claims.
  • Ability to administer multiple Health plans.
  • Auto-Adjudicate claims.
  • Handle year end IRS Tax reporting electronically and also print and send the provider 1099's
  • Flag claims for prior authorizations and accidents.
  • Track accidents and subrogation.
  • Enter and attach prior authorizations and deny on exceeding the limits.
  • Send out EOB, Provide paylist, Checks and Correspondence for Additional information.