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

Accidents

No one likes an accident but with smart detection by SIMPAL you can automate letter generation, record keeping and subrogation.
Accidents
Dental Claims

Dental claims are different and you need smart adjudication that factors in enclosures, accidents, prosthesis, orthodontics, tooth numbers,surfaces and much more.
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.