PBM Express Adjudication Software
The core of PBM Express is the adjudication program. Claims undergo hundreds of edits to achieve accurate processing results, regardless of the difficulty of the plan design. The parameter drive program provides for an extremely flexible architechture that allows for client customization as needed. Laker's advanced software solution provides clients with superior performance and industry-leading uptime.
PDEFixer is Laker's easy-to-use, automated workflow tool that allows PDE rejections to be viewed, corrected and resubmitted without the need for separate spreadsheets or entries. PDEFixer saves time and effort by fully managing rejections. Additionally, the process is fully tracked at every level, allowing for complete audit capability.
Call Center Software Module
Laker offers a Call Center Software Module that is fully integrated to the adjudication system. Call Center personnel have permission-based access to real time information to greatly improve problem solving and upgrade member satisfaction. User-friendly screens with drill down capabilities are designed to allow quick access to information needed. With Lookup, Reporting, and Prior Authorization advantages, this Module offers vastly improved overall Call Center efficiency.
Real Time Reporting
Laker’s sophisticated, ad hoc reporting platform allows users to remotely access any type of report or data needed at any time and from any location. The secure, easy to use application was developed to give you (and your clients) the reporting ability necessary to make the best informed clinical and financial decisions.
Laker’s BtB Switch is a Multi-threading Switch product designed for clients that are sending and receiving claims data from more than one IP address. BtB connects and handles traffic between the major switches, your company, and your claims adjudication program. It also can accept multiple files before sending a response and can route any BIN/PCN to any IP/TCP port combo. The BtB Switch is a component of the Laker system but can also be used with other adjudication programs.
Laker's multi-functional Member Eligibility Loader is a great tool that will allow users to load an eligibility file directly from their client into the live database. Prior to applying any changes to the live database, this tool enables users to modify errors within imported data. Additionally, the imported file is first compared against the remainder of the client's book of business. The results of that comparison are displayed to the user prior to being applied to the live database. Member Loader has been designed to make the eligibility process efficient, precise, and user friendly.
Through WebReportsExpress, Laker clients give their customers access to standard and custom reporting through a secure, easy-to-use web portal. The portal, privately labeled by the client, includes Audit Reports, Executive Summaries, KPI Reports, Top N Reports, Member Profiles, Prescriber Profiles, Utilization Detail Reports, Utilization Summary Reports, and more. The reports have drill-down capability and can be generated immediately or scheduled for auto-generation.
PaX Re - Automated Prior Authorization
PaX Re is an automated prior authorization system that utilizes preset definitions to adjudicate prior authorization requests. By comparing a members profile against these preset definitions, the system is able to process a request with no manual client intervention. The PaX Re system will create a prior authorization that is returned to the pharmacy without evidence of a rejected claim, expediting the overall process.
Laker’s ePrescribing service, through our relationship with Surescripts, allows physicians to electronically and securely send prescriptions from their offices to the patient’s pharmacy. Eligibility is real time and physicians have access to their patient’s prescription benefit and medication history, which improves safety and lowers costs.
Claims Reprocessing Module
Initially developed for Medicare Part D plans, the Claims Reprocessing Module allows Laker customers to reverse and reprocess batch claims to test new adjudicator functionality, new plan setups, or changes to existing plan setups. With simple to use screens, customers can quickly and easily compare how the original claims paid along with the new reprocessed claims. Additionally, the Claims Reprocessing Module can be used for numerous other reprocessing purposes.
Member Web Portal
Laker's integrated systems can help you take your Member Web Portal to the next level. From various lookups to actual - not estimated - copay information, your members will have secure information and tools at their fingertips, improving health and increasing efficiency.
APAR - Accounts Payable/Receivable
Laker's APAR™ (Accounts Payable Accounts Receivable) software was designed to help clients more efficiently Track, Bill, and Pay clients and Network Pharmacies. Advanced software allows for multiple cycles, schedules, and other billing and payment options.
Web Based Document Archiving
Web Based Document Archiving allows users to Scan and Archive paper documents as well as to easily manage and retrieve these documents through a secure on-demand “Electronic File Cabinet.” Authorized users manage configuration and permission data in the Dash III database, including Image Groups, Lookup Indexes, User Permissions, and Security Levels. Dash III has a detailed Audit History and can interface with your Enterprise Resource Planning (ERP) system and/or your Human Capital Management (HCM) system.
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