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I-CAPS is an Intelligent Claims Administration System that addresses all functional areas of the health claims payment environment with a single common architecture that spans the needs of payers including membership, billing, enrollment, mailroom, claims, network management, contracting, pricing, utilization review and customer service.

Since 1981, W.O. Comstock & Associates has been delivering health care solutions that address the needs within the managed-care environment including claims entry and adjudication, claims edit, group administration, billing and enrollments, HMO/PPO management, EDI, utilization management, clinical encounters, marketing, and provider relations. Our Triadic Operability™ Architecture merges complex functional processes with knowledge-based business rules to create Intelligent Software that thinks like your most experienced claims and health care professionals making decisions for you automatically. Our clients can operate at higher efficiencies with the ability to spot physician overcharges, and poor practice patterns.  They can also design, build and administer plans that can respond to health care challenges while containing costs.

Our Intelligent Claims Administration System (I-CAPS) and our coding compliance software (Advanced Value Scale-AVS) , support knowledge-based decision-making to help our clients contain costs. Guaranteeing the integrity of Provider information has never been easier with (Advanced Network Administrator-ANA) while our (RB-UCR) is the industries first Resource Based, Usual Customary and RESPONSIBLE fee schedule based on RBRVS and NCCI. Need a check up for your plan or provider, use Cost Containment Audit and Recovery Services (CCARS) for a completely non invasive audit retrospective look at claims effectiveness.

W.O. Comstock & Associates, LLC. supports all forms of managed care and shared risk arrangements including: HMO, PPO, POS as well as Medicare and Medicaid.

Advanced Value Scale (AVS) eliminates fraud and abuse with intelligent coding and compliance logic. AVS performs over 1 million defensible audit combinations identifying inappropriate coding and incorrect payments to control costs.

Product List:

I-CAPS - Intelligent claims Adjudication and Processing System
DENTAL - Dental Module for I-CAPS
ANESTHESIA - Anesthesia Module for I-CAPS
FLEX - Flexible Spending Accounts for I-CAPS
BILLING - Billing Module for I-CAPS
TPA - Third Party Administration
AVS - Advanced Value Scale
CCARS - Cost Containment Audit Recovery Services

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