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  • Data management information systems designed to facilitate the submission of claims and/or possible denials accurately and efficiently. These systems typically consist of a combination of hardware and software. The hardware typically includes dedicated network servers and computers; the software consists of a dedicated software package that facilitates the submission of claims and possible claim denials. Some systems also include software intended to process supplemental provider claims (i.e., secondary claims) and/or to prevent, analyze, and track denied claims as well as assist in the resubmission of corrected claims (i.e., denial claims). Claim/denial financial management systems support all phases of the submission process including claims processing, remittance posting, eligibility verification, and statement processing. The systems may function as stand-alone systems or may be integrated in a hospital-wide financial data management information system network.
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