Eclipse Bill Review

The correct application of state-mandated Workers’ Compensation rules is a complex task that can save millions of dollars in overbilled medical claims. Eclipse utilizes the most sophisticated system logic in the industry for reducing medical bills down to state-mandated fee schedules and for applying extensive state specific rule validation. Whether incorporated into Eclipse WC as a powerful cost saving module or as a stand alone Bill Review system with the unique Heads Down design for fast data entry, Eclipse is a powerful tool when used as part of an overall managed care plan. Some of the key features in Eclipse BR include:

• Comprehensive state rule application and validation — Eclipse Bill Review utilizes the most power and sophisticated system logic in the industry for achieving the highest degree of savings below state mandated fee schedules. After the application of the fee schedule, Eclipse validates the extensive state-specific rules for each fee schedule, as well as comprehensive correct coding edits to deliver an unparalleled level of combined savings either stand alone or bundled with Eclipse Claims.
• National and regional PPO option — Having one PPO network doesn’t always deliver the most comprehensive savings across all regions of the country. Eclipse Bill Review is configurable for multiple PPO networks and even has user defined options for the creation of specific local or regional contracts.
• Integrated Utilization Review Management — Eclipse assists the medical review process by integrating utilization review flags to monitor, claim by claim, the duration and frequency of services with an emphasis on Physical Therapy and Chiropractic.
• Extensive data validation and duplicate billing detection —
  Built into the system are extensive data validation fields for immediate error detection as well as duplicate bill detection right at the data entry level.
• Detailed, state-specific explanation of reviews (EOR) — Eclipse Bill Review provides a complete explanation of review customized by state of claim. 
• Heads Down design for data entry — The move from DOS based applications to Windows caused a loss of production in data entry due to the addition of the mouse and the accompanying keyboard re-engineering. Eclipse is designed to be used without a mouse in order to maximize Heads-down data entry.
• Bill notes — Each screen of the data entry process comes with note fields that are designed to hold pertinent data specific to that field.  These notes can be viewed across all levels of the organization, or restricted though the use of the system administrator.
• State defined EDI — EDI requirements can be complicated to program and administer. Eclipse comes pre-loaded with state-specific EDI formats designed to easily meet compliance requirements with a variety of state and national mandates.

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