E-COMB is a web-based medical billing software that allows users to generate and submit insurance claims electronically in compliance with HIPAA standards. It facilitates end-to-end claims processing, from entering patient and claims data, automatically generating billing forms and transactions, submitting claims electronically or by fax/mail, and reconciling claims with explanation of benefits received from payers. The software provides tools to customize the system, generate reports, and integrate security features to control user access.

1. Approved by
Blue Cross
Blue Shield of
Michigan
Claim Faster! Use E-COMB, the software Generate Claims
solution for generating all your Medical For all enrolled patients, claims can be generated to submit
Claims electronically, faster, easier, and to the appropriate Payer for the services provided. To gen-
friendlier… erate the claims, E-COMB searches for all the unbilled serv-
ices that were recorded into the system for every patient.
EDI Compatible Medical Billing (E-COMB) is a web based However, before the claims are submitted to a Payer, they
solution for generating medical claims complying with the can be manually audited for accuracy. E-COMB generates
HIPAA transaction and code set standards, regulated by the the transactions as defined in the 837-transaction set of the
US Government following the recommendations of American HIPAA regulations
National Standards Institute (ANSI). The application is
designed to generate, submit and reconcile the claims to the Submit Claims
insurance carriers, guarantors and/or patients. This is one of Claims are submitted to the Payer in the form of transactions.
the most important tools for doctors in realizing their revenue Each transaction can be bundled to have multiple claims
by reducing the turn around time in the claims reimburse- either related to the same patient or to different patients. E-
ment. COMB facilitates the generation of the transactions for all
the pending claims once manual audit of the claims is com-
Initial set up pleted as desired. These transactions can be sent either elec-
All the information related to environment of the Doctor’s tronically or manually by fax/mail. All the transactions that
Office/Hospital is grouped together as Master Data. This need to be sent in manually can be printed on the HCFA
information is frequently used for claims processing and is 1500 forms. For shorter turnaround time for payments, elec-
less likely to change quite often. Master Data contains tronic transmission is recommended.
details of the Procedures, Diagnoses, Doctors, Payers, and
Billing Providers etc. This data is created as part of the ini- Reconcile
tial set up and can be updated easily at any time. E-COMB E-COMB automatically interprets the payment/advice
provides the cross-links at all appropriate levels in the appli- received from the Payers. The data received from a Payer
cation for the Master Data to be connected to the patient through 835 transactions is imported into the database and
and subsequently to the claim automatically. displayed as viewable screens. Payments received through
non-electronic methods are entered manually. Using the data
Patient Enrollment generated for submitting the claims and also the data import-
To facilitate the ease of dealing with vast amount of infor- ed as part of settlement from the Payer, Coordination Of
mation, E-COMB provides versatile access to patient Benefits (COBs) is handled hassle free. Fully automatic and
records. Patient information, including their demographics, semi automatic approaches provided in the application help
Subscriber, Guarantor/Responsible Party information can be for a smooth switch over to complete compliance of HIPAA
entered into the system at the time of enrollment. This infor- transaction code sets.
mation can be modified at any time. All the patient data is
grouped together at multiple levels. Data for all the services Reports
performed on a Patient can be entered using the service E-COMB will provide several reports related to Patients,
level screens. The functional flow of the application is Services and Claims. Sorting order and filtering criteria can
aligned with a typical process followed in a life cycle of a be defined on these reports to attain any level of detail.
service. Details of the services provided can be keyed into Reports can be printed on paper or exported to other appli-
the system right after they are performed. Detailed claim cations or to a flat file. Pie charts and bar graphs can be
related information could then be entered or modified using generated.
the claim level screens.
Security
E-COMB is smart to remember the names of recent patients. Through systematic use of Industry-standard security proce-
These patients can be selected from a list, for a quick access dures, the application makes sure that only authorized per-
to their information. Any patient can be searched for, by sons have access to the system. All authorized users are
entering the desired criteria.
KBTS Technologies, Inc.

2. KBTS Technologies, Inc.
given a User ID and a password with different access levels. Automatic Claim generation
For ease of operation, context based help facility is provid- Bundle different claims into one transaction
ed in the application. and submit it to the payer
Reconciliation of 837 and 835 transactions
Customization of E-COMB for proper COB
E-COMB is a web-based product that can be further cus- Audit Trials
tomized to meet your healthcare needs, irrespective of the Sophisticated Reports covering all operations
size of the organization or the type of data being accessed. that are handled under E-COMB
Scalability and modularity enables E-COMB to grow with Context based Help on each individual screen
the organization and facilitate making necessary changes Industry-standard, Multi-level security procedures
quickly. KBTS will work closely with the key personnel at your Work from anywhere
organization to customize this product to your requirements.
Software Installation
E-COMB runs on the Microsoft Windows XP/2000/2003
operating system. This can be installed on the hardware at
our customers’ facility or hosted by us outside their premises.
This application can be accessed from any location with
Internet access. With the superior level of support that comes
from KBTS, our customers can switch over to E-COMB with
no hassles for all the claims processing needs in their organ-
ization.
Summary of Features:
Electronic and manual claim generation,
submission and reconciliation
Compliance with HIPAA transaction and
code set standards
Send and receive EDI transactions
HIPAA EDI transaction sets implemented
and tested:
❖837 – Health Care Claim - ASC X12N 837 About Us
(004010X098A1) KBTS Technologies, Inc. is a software development firm
❖835 – Health Care Claim Payment/ headquartered in Novi, Michigan. We specialize in ERP, E-
Advice – ASC X12N 835 Commerce applications and Client/Server Technologies for
(004010X091A1) several industries including Healthcare, Pharmaceutical,
Code sets implemented: Manufacturing, Utilities, and Automotive.
❖CPT-4
❖ICD -9/ CM We assist in the strategic planning, design, development,
❖HCPCS deployment and support of any software application. Using
❖NDC our offshore development facilities, we offer cost effective
Master screens that are interwoven to have software development services that consistently deliver high
quick entry of data quality results. We provide rapid solutions to our customers’
Recent Patient list eases the process of needs and/or create a pipeline tailored to their anticipated
selecting patients needs. With the above qualifications, we guarantee that we
Enter Services as and when data is available can meet and exceed the expectations of our customers.
Pool the unbilled claims automatically
KBTS Technologies, Inc.
41461 West Eleven Mile Road, Novi, MI 48375
✆ 248.374.1230 fax: 248.374.1220 www.kbtstech.com