System and method for web-based claim management

Abstract

The system includes a variety of aspects which allow users to efficiently receive reimbursement for claims. Claims accepted by CMS result in reimbursement for claimants. Claims rejected by CMS represent lost revenue for claimants. In order to maximize accepted claims and minimize rejected claims, the system provides for the generation of more accurate PDE files for submission and for the accumulation and formatting of information received from CMS to facilitate correction of PDE errors. These aspects work in tandem to minimize lost revenue for the claimant. Further, aspects described herein help minimize PDE error rates. Such minimization of errors can affect the reputation, business model, credibility, and competitive posture of Part D plan sponsors. Accordingly, minimization of PDE error rates is important to the overall design, function, and profitability of any Medicare Part D plan sponsor.