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Eligibility Eddie
 
Electronic Eligibility Processing and Capitation Reconciliation Software for the EZ-CAP system
 
eddie  

This is one of the most popular services offered by CGC, loading electronic eligibility files from the HMO into the EZCAP system. Eligibility EDI Processor (software developed by CGC) converts and processes electronic eligibility and produces a file that can be loaded appropriately into the EZCAP system.

Eligiblity Eddie offers a unique approach to processing eligibility by comparing the HMO file with current eligibility records in the EZ-CAP system. As a result, the status of each HMO member record is appropriately identified as an Add, Re-Enroll, Change or Termination record. Each file loaded through EZ-LINK runs through smoothly and without conflicts or rejects.

 
Features
 
- COMPATIBLE WITH EZ-CAP 6.2!
- Capitation reconciliation with auto-correction options
- Inloads Benefit Options and Employer Codes
- Logs all statistical information for each inload file
- Corrects product transfers
- Quick fix feature for invalid member record info
- View all changes capability
- Accept or decline changes
- Creates detailed reports all member update transactions
  eddie
 
 
 
 
CHAD GAMELIN CONSULTING 2012