TIBCO Foresight Transaction Insight

Advanced Reporting

Get enterprise-wide, partner-specific, and detailed transactional reporting and alerts. And share that information with staff and partners who are responsible for improving performance.

• Business Activity Monitoring (BAM): Gain insight and control over your operation with detailed reporting, including success rates, errors, volumes and partner comparisons. All Transaction Insight reports can be filtered by transaction, partner, line of business and any other user-defined transaction-based element. Reports are also capable of export to Excel, pdf and other formats.
• Transmission Reporting: Track file transmissions and communicate success/failure status and find errors within a file with detailed transmission reporting.

Secure Portal Technology

View, share and correct transactions through Transaction Insight's secure portal, or link to your existing portal to provide reporting and transaction access.

• Strict Access Controls: Guard against unauthorized access to information with role-based access permissions for the Transaction Insight portal, ensuring partners and staff can only view and edit information based on partner, transaction type, error type, line of business and more.
• Internal Portal: Let your staff access reporting and transactional detail to your staff so they can answer questions on the first call. You can even link to external systems via APIs and web services to feed related information like claim status, so they don't have to log-in to multiple systems.
• External Portal: Share performance reporting and error correction capabilities directly with the original submitters, so they can identify and fix their own problems without calling your help desk.
• Error Correction Facilities: Transaction Insight offers specialized form-based error correction facilities for claims, enrollments, payments and eligibility. Your staff will save time researching and resolving problems.

Research Capabilities

Save time answering questions with advanced search and transaction matching capabilities.

• Facilitated Searches: Easily find specific documents from the Transaction Insight database with a powerful search function. Upon selection, documents are displayed in a familiar form-based view with errors clearly noted, so your staff can answer questions on a single phone call.
• Document Matching: Access related documents through rules-based matching, including –
  • Claim / payment
  • Claim / claim attachment
  • Eligibility request / eligibility response
  • Status request / status response

Key Benefits

• Reduce expenses related to research and re-work through improved access to information and on-screen display and error correction.
• Reduce call volume by empowering your partners to view status of claims and other transactions.
• Improve partner performance through detailed performance reporting, access to view claim status, and the tools they need to correct and resubmit transactions.
• Improve provider and member relations with fewer rejected transactions and faster correction time.

Transaction Insight Specialty Applications

There's no one-size-fits-all solution. That's why we've created specialized data validation, presentation and error correction modules as extensions of the Transaction Insight Automation Platform:

• TIBCO Foresight™ Claims Correction Manager: Accelerate and improve claim transaction processing through improved validation, reporting and correction of HIPAA 837 and 27X claim transactions.
• TIBCO Foresight™ Claims Attachment Manager: Enable your partners to upload electronic claim attachments and associate them with the appropriate claim documents to reduce paperwork and speed decision times.
• TIBCO Foresight™ Enrollment Correction Manager: Validate and correct enrollment transactions in standard HIPAA 834 and proprietary formats to speed onbording of new members and reduce pended and rejected claims to failed enrollments.
• TIBCO Foresight™ Payment Correction Manager: Accelerate payment reconciliation by ensuring HIPAA 835 remittance advice files are balanced and accurate before claim payments are made.