{"id":255,"date":"2022-08-18T01:40:42","date_gmt":"2022-08-18T01:40:42","guid":{"rendered":"http:\/\/wltsoftware.flywheelstaging.com\/?page_id=255"},"modified":"2025-06-05T12:47:08","modified_gmt":"2025-06-05T12:47:08","slug":"mediclaims","status":"publish","type":"page","link":"https:\/\/wltsoftware.com\/mediclaims\/","title":{"rendered":"MediClaims"},"content":{"rendered":"\n\n\t<p>CLAIMS ADJUDICATION SOFTWARE<\/p>\n<h1>\n\t\tYour Claims Solution for Efficiency And Cost Savings\n\t<\/h1>\n\t<p>MediClaims is WLT&#8217;s Claims Adjudication and Benefits Management Solution: technology that is cost-effective, straightforward, and efficient. Claims are processed quickly, easily, and accurately, with complete claims and benefit management capabilities.<\/p>\n<p>MediClaims is a user-friendly native Windows\u00ae application partnered with Oracle\u00ae, one of the most powerful databases available.<\/p>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/MediClaims_Logo-Registered.webp\" alt=\"MediClaims Logo\" itemprop=\"image\" height=\"551\" width=\"860\" title=\"MediClaims_Logo-Registered\" onerror=\"this.style.display='none'\"  \/>\n\t<p>Flexible Benefits and Claims<\/p>\n<h2>\n\t\tA robust benefit management solution.\n\t<\/h2>\n\t<p>MediClaims&#8217; benefit administration and claims processing capabilities encompass a range of benefit and claim types, from standard Medical, Dental, Vision, and Prescription Drug, to FSA, HSA, HRA, COBRA, Disability, and HMO Capitation, as well as MEC and level funded plans.<\/p>\n\t<p>Sophisticated and Powerful Databases<\/p>\n<h2>\n\t\tAdvanced systems  and technologies at  your fingertips.\n\t<\/h2>\n\t<p>No plan can work efficiently without support from reliable information systems. WLT always works with the most advanced technologies, providing you with the most sophisticated and flexible systems available today.<\/p>\n<p>MediClaims is a user-friendly native Windows\u00ae application partnered with Oracle\u00ae, one of the most powerful databases available.<\/p>\n<h2>\n\t\tMediClaims is our flagship solution for:\n\t<\/h2>\n\t\t\t\t<img decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-324.svg\" alt=\"Settings gear with pencil\" itemprop=\"image\" title=\"Group 324\" onerror=\"this.style.display='none'\"  \/>\n<h3>\n\t\tClaims Management\n\t<\/h3>\n\t<p>Claims processing for medical, dental, vision, and prescription drug plans<\/p>\n\t<p>Claim precertification, referral, and case management functionality<\/p>\n\t<p>Capitation maintenance and payment processing<\/p>\n\t\t\t\t<img decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-325.svg\" alt=\"Credit Card\" itemprop=\"image\" title=\"Group 325\" onerror=\"this.style.display='none'\"  \/>\n<h3>\n\t\tAdministration &#038; Billing\n\t<\/h3>\n\t<p>Consumer-driven healthcare benefits administration, including FSA, HRA, &amp; HSA<\/p>\n\t<p>COBRA administration<\/p>\n\t<p>Eligibility administration<\/p>\n\t<p>Disability processing for both short and long-term benefits<\/p>\n\t<p>Premium billing and agent commissions<\/p>\n\t<p>Easily configurable system security<\/p>\n\t\t\t\t<img decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-382.svg\" alt=\"Network with a check centered\" itemprop=\"image\" title=\"Group 382\" onerror=\"this.style.display='none'\"  \/>\n<h3>\n\t\tData Management\n\t<\/h3>\n\t<p>Customer service contact management<\/p>\n\t<p>An extensive library of standard and custom reports<\/p>\n\t<p>HIPAA-compliant EDI 5010 and legacy 4010 transactions<\/p>\n\t<p>Discover more<\/p>\n<h2>\n\t\tThe MediClaims<br \/>Advantage\n\t<\/h2>\n\t<p>To fully see how our system can help you save time, reduce cost, and increase your operation&#8217;s compliance, please share your contact information and we will schedule a confidential demo session.<\/p>\n\t\t\t<a href=\"\" target=\"_self\">\n\t\t\t\t\t\t\tStart the Discovery\n\t\t\t<\/a>\n<h2>\n\t\tClaims and benefits software powered by capabilities\n\t<\/h2>\n\t\t<nav>\n\t\t\t<ul>\n\t\t\t\t\t\t\t\t<li data-index=\"0\" tabindex=\"0\">\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t<a href=\"javascript:void(0);\" tabindex=\"-1\">Claims Processing &#038; Editing\n\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/h4>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li data-index=\"1\" tabindex=\"0\">\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t<a href=\"javascript:void(0);\" tabindex=\"-1\">Administration &#038; Billing\n\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/h4>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li data-index=\"2\" tabindex=\"0\">\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t<a href=\"javascript:void(0);\" tabindex=\"-1\">Compliance &#038; Reporting\n\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/h4>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li data-index=\"3\" tabindex=\"0\">\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t<a href=\"javascript:void(0);\" tabindex=\"-1\">Consumer-Driven Healthcare\n\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/h4>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li data-index=\"4\" tabindex=\"0\">\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t<a href=\"javascript:void(0);\" tabindex=\"-1\">Security\n\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/h4>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li data-index=\"5\" tabindex=\"0\">\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t<a href=\"javascript:void(0);\" tabindex=\"-1\">Web Portals\n\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/h4>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<\/ul>\n\t\t<\/nav>\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t\t\t\t\t\t\tClaims Processing &#038; Editing\n\t\t\t\t\t\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-318.svg\" alt=\"Settings gear with pencil\" width=\"90\" height=\"105\" \/><\/p>\n<h4><strong>Claims Processing &amp; Editing<\/strong><\/h4>\n<p>WLT&#8217;s user-friendly interface and processes allow claims to be processed quickly, accurately, and easily in real-time.<\/p>\n<p><strong>MediClaims&#8217; processing and editing capabilities encompass a range of claim functions from:<\/strong><\/p>\n<ul>\n<li>Standard Medical, Dental, Vision, and Prescription Drugs<\/li>\n<li>FSA<\/li>\n<li>HSA<\/li>\n<li>HRA<\/li>\n<li>Disability<\/li>\n<li>HMO Capitation<\/li>\n<li>Medicare Supplement<\/li>\n<\/ul>\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t\t\t\t\t\t\tAdministration &#038; Billing\n\t\t\t\t\t\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-322.svg\" alt=\"Credit Card\" width=\"90\" height=\"105\" \/><\/p>\n<h4><strong>Administration &amp; Billing<\/strong><\/h4>\n<p>The MediClaims system&#8217;s intuitive user interface simplifies the administrative duties of the Benefit Administrator. Precertification, Eligibility, PPO Administration, Letter Writing, and Call Tracking are just a few of the many features designed to save you time and money. WLT&#8217;s flexible plan design allows you to have multiple plan options at the group and individual levels.<\/p>\n<p>The Premium Billing &amp; Agent Commissions portion of our system allows you to effortlessly bill for premiums and collect payments. Billing can be performed at the group, location, or even the individual level. And to top it off, distributing commissions for collected premiums is also made easy.<\/p>\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t\t\t\t\t\t\tCompliance &#038; Reporting\n\t\t\t\t\t\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-195-1.svg\" alt=\"Form with a shield\" width=\"90\" height=\"105\" \/><\/p>\n<h4><strong>Compliance &amp; Reporting<\/strong><\/h4>\n<p>WLT understands that a critical aspect of a benefits administrator is compliance with various federal laws. WLT continuously monitors evolving federal requirements to determine how to help automate the required processes through our system&#8217;s functions.<\/p>\n<p><strong>Some of our compliance features are:<\/strong><\/p>\n<ul>\n<li>NSA &amp; TiC Compliant<\/li>\n<li>COBRA Qualifying Event Notification Letters<\/li>\n<li>PCORI and Transitional Reporting for ACA<\/li>\n<li>1094-C &amp; 1095-C Forms and Electronic Filing<\/li>\n<li>HIPAA EDI Compliance<\/li>\n<li>835 CAS Reason Code Mapping<\/li>\n<li>835 RARC Code Mapping<\/li>\n<li>1099 Forms and Electronic Filing<\/li>\n<li>W-2 Forms and Electronic Filing<\/li>\n<\/ul>\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t\t\t\t\t\t\tConsumer-Driven Healthcare\n\t\t\t\t\t\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-196-1.svg\" alt=\"Phone with heart on it\" width=\"90\" height=\"105\" \/><\/p>\n<h4><strong>Consumer-Driven Healthcare<\/strong><\/h4>\n<p>The popularity of consumer-driven healthcare plans has been on the rise in recent years. WLT&#8217;s MediClaims system can easily administer these plans and incorporate benefits with your health plan.<\/p>\n<p><strong>Some of the features of our Consumer-Driven Healthcare (CDHC) module include:<\/strong><\/p>\n<ul>\n<li>Flexible Spending Accounts (FSA)<\/li>\n<li>Health Reimbursement Arrangements (HRA)<\/li>\n<li>Health Savings Accounts (HSA)<\/li>\n<li>Automatic FSA payments for health plan out-of-pocket expenses<\/li>\n<li>Integrated HRA benefits in your existing health plans<\/li>\n<li>Administrative reporting and member statements that are specific to your FSA,<br \/>HSA, and HRA plans<\/li>\n<\/ul>\n<p>In addition to the above features, an integrated benefits card is available. The WLT MediCard Benefits Card can be used by your members to settle point-of-service transactions directly from their available CDHC funds.<\/p>\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t\t\t\t\t\t\tSecurity\n\t\t\t\t\t\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-317.svg\" alt=\"Shield with check mark inside\" width=\"90\" height=\"105\" \/><\/p>\n<h4><strong>Security<\/strong><\/h4>\n<p>All your data is safely stored in the award-winning Oracle database and is exportable in virtually every format (Excel\u00ae, Word\u00ae, PDF, etc.). The databases are encrypted with advanced techniques to ensure your data&#8217;s protection, and MediClaims adds additional layers of security by customizing access to programs through multiple roles in the company. System security reports help authorized personnel identify every program a user can access, ensuring your configuration has the desired results.<\/p>\n\t\t\t\t\t<h4>\n\t\t\t\t\t\t\t\t\t\t\t\tWeb Portals\n\t\t\t\t\t\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/wltsoftware.com\/wp-content\/uploads\/2022\/09\/Group-316.svg\" alt=\"World icon\" width=\"90\" height=\"105\" \/><\/p>\n<h4><strong>Web Portals<\/strong><\/h4>\n<p>Our Web Portals grant users an innovative, streamlined approach to benefit and claims management, while continuing the tradition of excellence our Clients have come to expect.<\/p>\n<p>Full integration with the core WLT systems provides instant data access, allowing for more dynamic automation of Enrollment, Member Registration, Call Tracking, and much more.<\/p>\n\t\t\t\t\t<!-- \/content -->\n\t<!-- \/tabs -->\n\n","protected":false},"excerpt":{"rendered":"<p>CLAIMS ADJUDICATION SOFTWARE Your Claims Solution for Efficiency And Cost Savings MediClaims is WLT&#8217;s Claims Adjudication and Benefits Management Solution: technology that is cost-effective, straightforward, and efficient. Claims are processed quickly, easily, and accurately, with complete claims and benefit management capabilities. MediClaims is a user-friendly native Windows\u00ae application partnered with Oracle\u00ae, one of the most [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-255","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>MediClaims: Your Solution for Efficiency And Cost Savings<\/title>\n<meta name=\"description\" content=\"This system offers not only the versatility to meet the different needs of each user, but also the adaptability to meet ever-changing industry trends.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/wltsoftware.com\/mediclaims\/\" \/>\n<meta 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