The System

ElectronicsAt the core of Global Exchange’s services and information management is our state-of-the-art modular managed care application system which is recognized as the nation’s leading and most widely used managed care software technology system. This system utilizes the power of Internet connectivity to materially enhance efficiency and drastically reduce related transaction costs. It is, therefore, the cornerstone upon which the claim of Global Exchange, Inc. as the premier location – – Where e-Business Meets Global Managed Care – – is based.

System modules include:

  • Benefit Plan Administration
  • Claims Processing
  • Electronic Claims Entry/Automatic Adjudication
  • Upcoding/Unbundling of Physician Bills
  • Physician Billing
  • Premium Billing/Processing
  • PPO Administration, Management and Repricing
  • HMO Capitation/Risk Pooling
  • Reinsurance Processing
  • Utilization Management
  • HIPAA Records To Satisfy Federal Guidelines
  • Customer Service

The system also hosts an array of Web-based products via direct/online secure access by our clients on a worldwide basis for:

  • Member Enrollment Via The Internet
  • Eligibility and Claims Status Inquiry
  • Automated/Consolidated Electronic Claims Acquisition
  • Claims Submission Via The Internet
  • Complete Remote Administrative Processing Capabilities Through, a Virtual Private Network (VPN).

These impressive, highly automated system components are adequately complemented by our expert data warehouse management and analytical system to generate for our clients customized, comprehensible, timely and, therefore, useful management reports they need to promptly see the results of operations and proactively manage their operations for desired corporate objectives.