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Electronic Claims Payment & Remittance

Our no-cost comprehensive claims payment solution converts both paper-based payments and remittances to electronic transactions, which allows you to:

  • Generate volume-based revenue share income.
  • Reduce banking and printing/mailing costs.
  • Streamline the overall claim fulfillment process for your organization.

Whether you’re an insurance carrier, a third-party administrator or a clearinghouse, you can rely on the AOC Solutions EnCompass platform to make efficient e-payments for your medical, dental, pharmacy, workers’ compensation and property/casualty injury claims. All electronically. All seamlessly. All at no cost to you.

Benefits for claims payers
Benefits for claims payers
  • Reduce the processing time and costs associated with administering check-based payments and claim remittance documentation.
  • Generate a new source of revenue for your organization (based on virtual payment volumes).
  • Increase cash float based on extended payment terms of virtual accounts.
  • Deliver virtual payments and claim remittance details through a single electronic channel.
  • Have the option to securely deliver industry-specific claim remittance file formats and documents to providers through an online portal.
Benefits for providers
Benefits for providers
  • Reduce revenue cycle time frames through receipt of quicker electronic payments.
  • Receive payments and claims from multiple payers through a single electronic channel.
  • Reduce processing time and costs associated with receiving paper checks and claim remittances.
  • Improve payment application and reconciliation through combined payment and remittance information.
  • Have the option to download claim details associated with payments.
Data security
Data Security
  • The AOC Solutions EnCompass platform is compliant with the Payment Card Industry Data Security Standard (PCI DSS) and the Health Insurance Portability and Accountability Act (HIPAA).
  • Stored data is encrypted based on leading industry standards.
  • Web access is highly controlled through Secure Socket Layer (SSL) encryption.
How It Works

EnCompass Healthcare Virtual Payments process flow

  1. The healthcare payer receives a claim for processing.
  2. The healthcare payer adjudicates and approves the claim for payment.
  3. The AOC Solutions EnCompass platform processes the payment electronically.
  4. Payment and the claim remittance advice are transmitted through one of the following methods previously chosen by the provider:
    • Provider-initiated pull payments — With a virtual account number assigned to a claim ID, locked down to the approved claim payment amount, the provider pulls the exact claim amount from the payer’s virtual account.
    • Payer-initiated push payments — The healthcare payer deposits funds for approved claims directly into the provider’s checking account.
  5. The healthcare provider receives the electronic payment and remittance advice for the approved claim.
Enrolling Your Providers
Enrolling your providers
  • Provider acceptance is key to a successful virtual payment venture for any claims payer. The more claims paid using the EnCompass platform, the more money you can save — and the more revenue you can earn.
  • Drawing on nearly 20 years of experience, we’ll consult with you regarding best practices and tips for success in provider enrollment.
  • We’ll also use every available resource to identify, contact, educate and enroll your providers. And we’ll review your provider lists periodically to determine if any need to be added or removed to optimize your success, with the ultimate goal of creating mutually beneficial, long-term relationships between you and your providers.
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