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OptiCHEQ
OptiCHEQ services include:
- Daily receipt of electronic claims from
optometrists.
- Claim checked against member benefits.
- Claim adjudicated down to line item level – pricing and rules.
- Ability to adjudicate according to any preferred provider arrangement.
- Electronic payment file is submitted to Scheme daily.
- Electronic reconciliation on website.
- OLTP - to contracted schemes.
- Profiles for optometrists.
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Improved database information allows accurate construction of all
pricing models.
All major switching companies are accommodated
for claim transfers, as well as various transfer methods.
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10 March 2010
Electronic claims
Confidentiality
Validations
Profiling of all service providers
Peer Review
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