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Average Ratings 0 Ratings

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ease
features
design
support

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Description

Paradigm Senior Services provides a comprehensive, AI-driven revenue cycle management solution designed specifically for home-care agencies that handle billing for various third-party payers, including the U.S. Department of Veterans Affairs (VA), Medicaid, and several managed-care organizations. The platform automates and enhances each phase of the billing and claims workflow, encompassing tasks such as verifying eligibility and authorizations, managing state- or payer-specific enrollment and credentialing, submitting accurate claims, addressing denials, and reconciling payments. It seamlessly integrates with widely used agency management software and electronic visit verification systems, enabling the scrubbing of shifts, weekly authorization verifications, and efficient payment reconciliations, all of which contribute to a reduction in denials and a lighter administrative load. Additionally, Paradigm offers "back-office as a service" for healthcare providers; this means that even if agencies have their own billing personnel or scheduling applications, Paradigm is equipped to manage claims processing, functioning as a dedicated, expert billing department. This flexibility allows agencies to focus more on patient care while leaving the complexities of billing in the hands of specialists.

Description

The Plan Administrator (TPA) serves as a comprehensive system for group enrollment, eligibility management, and consolidated billing. It features a centralized database that stores all pertinent information regarding clients, participants, dependents, coverage options, and associated rates. The system integrates all plans into a single billing statement and allows for electronic eligibility reporting and online enrollment. Rates are automatically calculated using various factors, such as age, tenure, and health risk assessments. Users can opt for summary billing or name list structures, and the platform supports easy data import and export through formats like CSV, composite files, or ODBC/SQL. With the CSPWeb module, the system can be accessed online, enhancing web functionality. Additionally, it automates all aspects of COBRA administration, managing everything from notifications to conversions. It also includes robust premium accounting capabilities, adeptly handling advance, partial, retroactive payments, and NSF checks. The system's compatibility with other software applications is seamless, utilizing ASCII, CSV, composite files, or ODBC/SQL for integration. Trusted by many of the largest administrators in the country since the inception of COBRA, this solution boasts over 25 years of proven effectiveness in the industry. With its extensive features and reliability, it continues to be an essential tool for effective plan administration.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

Paradigm

Founded

2015

Country

United States

Website

www.paradigmseniors.com

Vendor Details

Company Name

Benefit Plan Systems

Website

www.bencorp.com/index.html

Product Features

Home Care

Billing & Invoicing
Care Plan Management
Caregiver Management
Client Management
Field Communication
Insurance Management
Payroll Management
Scheduling
Visit Verification

Medical Billing

Claims Processing
Claims Scrubbing
Code & Charge Entry
Compliance Tracking
Customizable Dashboard
Dunning Management
Invoice History
Patient Eligibility Checks
Practice Management
Quotes/Estimates
Remittance Advice

Product Features

Benefits Administration

COBRA Administration
Claims Management
Deduction Management
Disability Insurance Administration
Employee Benefits Administration
FMLA Administration
FSA Administration
Flexible Spending Accounts
For Brokers
For Employers
HIPAA Compliant
Health Insurance Administration
Life Insurance Administration
Online Benefits Enrollment
Premium Billing
Provider Management
Retiree Administration
Retirement Plan Management

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