Personal Health Record at its simplest and its best. CompleMed^® - Personal Health Record, a cloud powered solution, also provides individual ownership of health information in a smart card format "Sterling Smart Health card System", is an enormously valuable, secure, comprehensive, portable and instantly accessible medical record over a lifetime. CompleMed^® provides complete health information from all service providers and individual health updates. It provides complete control on viewing, sharing and protecting the health data. Organize your doctor appointments. Set alerts and reminders. Manage your health better!

We perform audit of claims paid by Self-insured funds directly or through Third Party Administrators (TPA). Claims can be audited prior to payment to avoid over payment. We use our proprietary claims edit and adjudication platform to scrub the claims using well accepted claim payment criteria. We receive the claims in electronic format, apply necessary edits, prepare electronic file and transmit back to the payer all within 24 hours time period.

Our benefit administration software is best suited for Self-insured and self-administered health plans. Our comprehensive software incorporates Contribution Management including billing & receipt, Master Contract Maintenance, Eligibility & Cobra administration, Claim Processing (Medical, Hospital, Prescription Benefits, Vision, Dental, Hearing, etc.) and member and dependent administration.

The system also has Pre-authorization module, Member service module, Utilization Module, Case Management and Disease Management capabilities. The system has capability to import electronic Claims and export electronic EOBs mandated under HIPAA. The system also has EDI capability for Eligibility query, Claim status query and Pre-authorization requests.

Cloud powered practice management software for Healthcare providers (physicians and allied health practitioners) and hospitals. They are ideally suited for Practices both large and small. The software integrates functions such as Appointment Scheduling, Encounter recording, Billing insurance companies and patients, compliant EDI for all transactions such as Claim submission and response in electronic format, Submit and receive Eligibility, Claim Status Queries and response and electronic Pre-authorization services.  One of the distinguishing aspects of the software is its ability to auto post electronic EOB received from the payers and prompt for secondary insurance billing.

EDI Portal is cloud based software for payers who have their own fund software and would like to generate and send electronic fund transfer and electronic remittance to providers. We help the providers to receive re-associated ERA and EFT which reduces much of the phone calls they make.

Clearinghouse is the portal for payers and Providers for transmission of EDI. Clearinghouse receives electronic files (both HIPAA compliant and proprietary) and transmits between Providers of service and Payers.   Clearinghouse is fully compliant for Confidentiality and Security in addition to being certified for EDI.

Clearinghouse has the ability to test the following validation

• HIPAA
• Segment
• Loop
• Element
• Situation
• Code Set and Date

Transactions type supported by Clearinghouse

• EDI Health Care Claim Transaction set (837)
• EDI Health Care Claim Payment/Advice Transaction Set (835)
• EDI Benefit Enrollment and Maintenance Set (834)
• EDI Payroll Deducted and other group Premium Payment for Insurance Products (820)
• EDI Health Care Eligibility/Benefit Inquiry (270)
• EDI Health Care Eligibility/Benefit Response (271)
• EDI Health Care Claim Status Request (276)
• EDI Health Care Claim Status Notification (277)
• EDI Health Care Service Review Information (278)
• EDI Functional Acknowledgement Transaction Set (999)