| 摘要 |
A system for processing healthcare claims and remittances comprises a database and an electronic portal. The database contains previously received healthcare claims from a plurality of healthcare providers and previously received remittances from a plurality of payers. The electronic portal, connected to the database, receives a healthcare claim from a provider or a remittance from a payer, and splits the received claim or remittance into a plurality of data elements. The portal assigns a unique identifier and a shared identifier to each of the data elements of the received claim or remittance. The portal performs a duplicate claim edit and/or a third party liability edit on the received claim, or performs a duplicate remittance edit an/or a third party payment edit on the received remittance. Based on the result of the edits, the portal submits the received claim to a payer or submits the received remittance to a provider.
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