ABAS/TPA Speeds Your Claims Through Computerized Processing

For most people, the real test of the effectiveness of a health care program is whether they are reimbursed fairly and quickly for costs incurred. ABAS/TPA’s computerized claims processing system, QicLink™, through TriZetto® (RIMS), provides quicker handling while protecting the participant’s rights and your financial interests.

TriZetto, which focuses solely on healthcare, serves more than 500 payers, providers and benefits administrators. Its payer customers serve more than 100 million health plan members, or approximately 40 percent of the insured U.S. population.

QicLink significantly reduces claims processing costs while maximizing productivity. Its core system processes health claim transactions, including membership, provider files, plan of benefits definition and re-insurance. And, QicLink is optimized for high-speed, automated transaction processing. It is an extremely flexible system that offers IT outsourcing options, web-based trading partner interfaces and third-party solution choices. QicLink automates core administrative functions for more than 300 healthcare administrative clients, processing approximately 160 million claims annually. To further enhance the claims processing system, ABAS/TPA utilizes the following additional QicLink products: ClaimBatch, AutoDental, PPO, Premium Billing and Flexible Spending.

With the help of state of the art technology, ABAS/TPA’s claims processors verify eligibility, compare current charges to previously accumulated history, update provider payment information, and calculate allowable payments – in much less time than most systems permit.

Computerization, however, does not mean that your claims are handled by an inflexible machine. In any claims operation, adjustments and/or re-process exceptions occur; our programming capabilities allow for the level of flexibility you desire. And, our programs are designed to protect the security of plan data and funds. Complex computer codes assure access to your claim file only by authorized ABAS/TPA processors.