CWIBenefits utilizes a custom designed, proprietary software called ClaimsWare™. This product was marketed commercially for over 15 years. As a result of our expertise in claim system design and functionality, our clients feel secure in our ability to process claims accurately, quickly and efficiently. It has significant software intelligence that provides detailed edits necessary for claim processing. Edits such as multiple surgeries, duplicates, bundling and unbundling, age and gender may be customized to allow for a variety of claim review options. In addition, since CWIBenefits owns the ClaimsWare™ software, it can be customized to incorporate additional edits such as provider types, place of service edits, dollar limits and other parameters. While the ClaimsWare™ system carefully identifies these traditional edits, it can also add client specific programs and edits.
Our secure, modern, web-based employee benefits platform includes:
- Online enrollment – open enrollment, new hire enrollment
- One confirmation page for all benefits
- Multiple carrier benefits platform – no more multiple websites
- Employee benefits self-service, or call center assisted – do-it-yourself, or call a customer service rep
- Company HR department portal to benefits data
- Consolidated billing – we distribute all funds to all carriers
- Consolidated data exchange – update information once, we update all carriers
- Outcome Analysis/Predictive Modeling
- CWI created and utilizes the Claimsware™ system
- In-house developed, scalable systems
- Modular systems architecture
- Multiple networks for each group
- Multiple Benefit Plan structures
- Multi-tiered network plan administration
- Matrix plan (any combination of multiple deductible, out-of-pocket, and co-insurance options)
- Member portal (claims history, online ID Card, online EOBs, optional online enrollment)
- HR portal (claims history, document pickup, online reporting)
- Reporting (online self-service, standard monthly packages, and Account Manager assisted)
- Advanced analytical tools