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DIRECTORY OF BENEFIT INFORMATION AND CLAIMS SYSTEMS (PART FIVE OF SEVENTEEN)

Posted On: Mar. 2, 1997 12:00 AM CST

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Eldorado Computing Inc.

5353 N. 16th St., Suite 400, Phoenix, Ariz. 85016; 602-604-3100; fax: 602-604-3115

Benefit systems since: 1984.

Software systems:

*HEALTHpac.

Price: $80,000 to $200,000. Quoted individually.

System requirements: 486 PC; DOS, Windows 3.1 and above or UNIX platform; 16MB RAM, 500MB hard disk; VGA or SVGA video; multiple user; network operating systems supported include Novell Netware, Windows NT and UNIX; database management systems supported include DB/C Databus.

Customization optional.

First installation: 1984.

Total installations: 25 in employee benefit departments.

Benefits managed: Flexible benefits, disability, COBRA, group health plans, prescription, dental, vision.

Features: Enrollment, eligibility verification, claims management, multi-option coordination of benefits processing, aggregate and specific tracking, fund accounting, hour banking, case management, utilization review, explanation of benefits, accepts user-defined and multiple standard usual and customary fee schedules, batch checks, ad hoc report generation. Options include modules for managed care, PPO claims repricing, provider contract management, medical code unbundling, MICR encoded laser check, optical character recognition/intelligent character recognition scanning.

User support: User groups/meetings, onsite training, online support, telephone assistance eight hours per day.

Staff: 50 total, 30 professionals.

Clients: 125 total. Sold systems to 22 clients in 1996.

Officers: Zane Bell, president/CEO.

Contact: Robert A. Hass, vp-marketing, 602-604-3100, ext. 285.

Empire Medical

Review Services

P.O. Box 100, Thiensville,

Wis. 53092-0100; 414-238-1310;

fax: 414-238-1312

Software systems:

*ElectroniClaim.

Price: $5,000 to $50,000. Quoted individually.

System requirements: Pentium PC; Windows 95 or Windows NT platform; 16MB RAM, SVGA video; multiple user; network operating systems supported include Novell Netware and Windows NT; database management systems supported include MS-SQL and most desktop.

Customization optional.

First installation: 1995.

Benefits managed: Workers comp, group health plans.

Features: Receiving software supporting professional services and hospital bills; insurer direct in HCFA; supports all major electronic claim formats, including UB92 and ANSI 837; clearinghouse support for NEIC medical and hospital claims; enhanced error checking and reporting; unattended file upload and download through electronic bulletin board system, code files included; laser printing of forms and data, help windows.

User support: User groups/meetings, onsite training*, telephone assistance eight hours per day*.

Staff: Five total.

Clients: Four total. Sold systems to three clients in 1996.

Officers: Robert W. Thickens, president.

Contact: Robert W. Thickens.

**Included in system price.

Erisco Inc.

1700 Broadway, New York,

N.Y. 10019; 212-765-8500;

fax: 212-582-8030Benefit systems since: 1968.

Parent: Cognizant.

Software systems:

*ClaimFacts.

Price quoted individually.

System requirements: MVS or VSE platform; VGA video; multiple user; network operating systems supported include IBM LAN Manager; database management systems supported.

First installation: 1980.

Total installations: 101 in employee benefit departments.

Benefits managed: Workers comp, disability, group health plans.

Features: Eligibility verification; duplicate search; coordination of benefits checking; claims benefit determination; payment computation; automatic claims adjudication; single screen processing; online file maintenance; automated correspondence. Options include periodic enhancements.

*Facets.

Price quoted individually.

System requirements: 486 PC; Windows 95 platform; 16MB RAM, 330MB hard disk; VGA video; multiple user; network operating systems supported include IBM LAN Manager; database management systems supported include Sybase.

Internet/intranet access.

Customization optional.

First installation: 1993.

Total installations: 16 in employee benefit departments.

Benefits managed: Group health plans.

Features: Online and batch claims processing, claims prepricing, referral management, hospital and ambulatory preauthorization, case management, customer service, group/membership authorization, plan/product and benefit calculations, provider network management, premium billing and receivables, capitation/risk fund accounting, reporting. Options include periodic enhancements.

*GroupFacts.

Price quoted individually.

System requirements: MVS or VSE platform; VGA video; multiple user; network operating systems supported include IBM LAN Manager; database management systems supported.

Customization optional.

First installation: 1980.

Total installations: 32 in employee benefit departments.

Benefits managed: Disability, leave of absence, COBRA, group health plans, life insurance.

Features: Online administration of traditional group health plans, including enrollment, premium billing, commissions, membership and benefit functions. Options include periodic enhancements.

User support: User groups/meetings*, onsite training*, online support*, telephone assistance 24 hours per day*.

Staff: 239 total, 209 professionals.

Officers: Anthony Bellomo, president; Joseph Posluszny, senior vp/CFO; John Jordan, vp-sales; Rich Kerian, vp-operations.

Contact: Maribel Dominquez, 800-537-4726.

**Included in system price.