Dispute Resolution Management

The system manages the dispute resolution process starting from creating the list of dispute items, and ending with resolving the issues, and reflecting these resolutions in accounting. The resolution is about Mediation, Arbitration, and Settlement. The following highlights these areas:
System Manages the Mediation as follows:
  • Automatically constructs the initial dispute items, and then the user can add/Remove from it
    The dispute items are based on the non-resolved OCF-9 issues, which were never resolved in a dispute resolution process.
  • The system allows the user to select in an easy way the documents that may be needed
    The user will be able to browse / view / select / print any case related documents, and the system will provide automatic summary of each selected document .
  • The system will allow user to define the documents needed from insurance
  • The system will allow the user to review any details regarding the dispute items.
  • The system will print comprehensive report to be used in the mediation meeting.
  • The system will print the mediation request.
  • The system will follow-up the mediation proceedings as it happens (Like when the Mediator is defined / Meeting held / Mediation ended / Items resolved) .
  • The system will Implement any resolutions (partial or full) into accounting (both the client and the health service provider and the firm).

System Manages the Arbitration process in a similar manner like mediation

System Manages the Settlements as follows:
  • All what is needed is to enter the Gross settlement account, and a full detailed list of figures will be calculated based on the agreement terms.
  • The system provides full details on every displayed figure by user request. For example Loan Balance The user can view the case statement of account. Another example would be how the system calculated the Final client resolution amount.
  • The system will implement all the agreement terms in the process
  • The system will post all the accounting figures to the accounting module and settle all related accounts.
  • The system Allows any number of settlements.
  • The system prints settlement report based on the user defined settlement template.