OptiCare's Claim IT© is a proprietary, state-of-the-art claims editing software application. Payor organizations can gain a substantial competitive advantage through employing Claims IT© to reduce medical and administrative costs. OptiCare's Claim IT© is a pre-payment tool that works in conjunction with your current claims adjudication process. Claims violating CMS (formerly HCFA) Global Periods, CMS Bilateral Service Rules, Correct Coding Guidelines and Local Carrier Policies are automatically identified. The program is flexible and can be customized to work seamlessly with your current claims adjudication system.

Using OptiCare's secure web server, clients provide OptiCare with live, view-only access to certain specific claim software application fields. This in turn will generate a report back to the client on a daily basis (Monday through Friday) identifying eye care claims that represent overpayment to providers. Clients can then make appropriate adjustments to provider reimbursements before overpayment is made.

The core logic behind this exciting program is not locked in a "black box", but rather is well documented so that clients have the opportunity to review each and every rule that makes the system work. These rules represent universally recognized CMS, Correct Coding and Local Carrier Policy guidelines. There is no "fuzzy logic" and no controversial rules are utilized.

OptiCare's Claim IT© is non-invasive and everything needed to employ the system is provided by OptiCare. Furthermore, the software program is continually upgraded and monitored by OptiCare's experienced staff. Claim ITŠ can generate measurable savings of your healthcare dollars at a time when there is a great deal of pressure for health plans to maintain high quality of care standards, while reducing costs.

To request more information on OptiCare's proprietary Claim ITŠ program contact: Sales@OptiCare.net.