Provider Access System

The images below were taken from the EPOS Manual, which is given to all Providers during their PAS training.

The Main EPOS Screen.  In the image above, an eligibility check has been performed on 3 claims: 1) a general office visit; 2) a hepatitis vaccination; and 3) a tooth extraction.  The red lines through the latter 2 claims indicate that if submitted, they would be rejected.

The Response Summary Window.  This image reveals why the hepatitis vaccine would be rejected.  The red arrow points to a message which indicates that this particular benefit is not covered by the patient's policy.

PAS’ Billing Window, containing payment & next appointment information. Note that in this case since the patient is tendering a total of $800JA, the remaining $262.50JA will appear on the receipt as a balance. 

A receipt generated by EPOS.  Note that there is an authorization number under each procedure.  It is these numbers that bind the carrier to pay (in this case) $400JA for the general office visit, and $1600JA for the cardiovascular stress test.

Explanation of Benefits Report (EOB).  This report is generated by EPOS, and provides users with an itemized summary of how much was charged, how much was collected from patients, and how much the insurance carrier is expected to pay.  In this example, Dr. Smith rendered $3600JA in services; she collected $2920JA from the patient, and she is expecting a cheque from the insurance carrier for $680JA.  

Click here to view a PowerPoint^® presentation on the EPOS.

Click here to view a PowerPoint^® presentation on the "Tools and Rules" of Prohealthi--the claims processing application.

 [Home]  [About Us]  [News]  [Help]  [Site Map]

All rights reserved.  Copyright © AIS Limited  2001 [Legal]