What is PAS?
The Provider Access System (PAS) is an online, real-time health claims adjudication system that can accommodate all types of Healthcare Providers (medical, laboratory, hospital, pharmacy, optical, diagnostic and dental). PAS allows Providers to perform online, real-time eligibility checks prior to rendering services or dispensing medications. In so doing, PAS confirms patients' and customers' status with an insurance company before any of the Provider's resources are expended. Upon completion of the eligibility check, Providers can officially (and electronically) submit a claim (online real-time) directly to an insurance carrier using PAS. In this way, the Provider's payments are guaranteed, and the paperwork associated with submitting health insurance claims is reduced to subscribers signing a PAS-generated receipt, which produces an audit trail for the Carrier.
All of this is facilitated by a one-of-a kind, first in the world, online real-time claims processing application, that for all its sophistication is intuitive and permits Carriers to easily set up all of their plans and associated eligibility rules in an Oracle database. Industry standard codes such as ICD 9/10, CPT, ADA and drug codes are used as building blocks, along with editing tools such as; quantity over time, benefit and plan maximums, exception lists, number of occurrences, UCRs, etc., to define benefits down to their minutiae. PAS will adjudicate any claim, base or major medical, within 3 seconds and provide both the Carrier and the Provider with the finest audit trail for easy reconciliation.
Redundancy is a hallmark of PAS' design, and "simplicity" is a word that our users frequently associate with the Provider Access System. Since its network is based on IP/VPN, we have introduced e-mail to facilitate Carrier-to-Provider and Provider-to-Provider communication. This has enhanced communication tremendously whilst reducing paper and allied costs to their barest minimum.
PAS was developed as a joint venture between PHi of Chicago (a fully owned subsidiary of McKesson HBOC), Advanced Integrated Systems of Jamaica, and Health Adjudication Systems of Grand Cayman (AIS' equity partners).