iWORKS GBAS provides group health claims and benefit administration software solutions for insurance companies, third party administrators, and self-administered employers. Combining 30 years of evolving business logic with the latest open technologies, iWORKS GBAS offers the most functionally rich, flexible, automated benefits and health claims administration system in the industry. iWORKS GBAS has a proven track record of controlling costs by maximizing claims auto-adjudication and automating all key business processes.
Known for its ability to handle different lines of business in an automated fashion, iWORKS GBAS allows your organization to quickly capitalize on emerging markets. With the use of the latest open technologies, iWORKS GBAS provides superior information sharing capabilities and connectivity to quickly integrate with complimentary systems and partners reducing time to market and delivering rapid return on investment.
The Three Main Components of iWORKS GBAS
The Admin module stores the data and executes the processes necessary to administer eligibility, billing and finance, certificates and ID cards, COBRA, and reports on the group or aggregate characteristics.
The Claims module is designed with automation in mind. Sophisticated plan building and workflow functionality allows the incorporation of system executed business logic for validating eligibility, adjudicating claims, and printing checks and EOBs. iWORKS GBAS Claims is known as one of the most powerful adjudicating engines in the industry.
The CDH Suite supports the administration of high deductible health plans complimented by FSA and HRA fund accounts. The system is integrated with core iWORKS GBAS allowing for the automated orchestration of plan components. Seamless debit card integration allows for a comprehensive consumer driven strategy.
Benefits
- Enterprise wide automation significantly reduces cost per transaction maximizing return on investment.
- Reduce time to market with new products and services.
- Automate key business processes including workflow, pended claims distribution, customer service, EDI, imaging, and document management
- Efficiently manage key healthcare transactions including eligibility, AR/AP, adjustments, reinsurance, plan design, and auto-adjudication.
- Multi-role real time web portal to facilitate web based consumer interaction, integrated specifically for iWORKS GBAS enrollment, eligibility transactions, and claim inquiry.
- Supports HIPAA EDI, privacy and security regulatory compliance requirements
- Modular yet integrated ensuring flexibility to optimize solution to specific needs
- Powerful reporting tools ensuring timely delivery of information.
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