Esorse Corporation – Pay Direct Card

Hybrid health benefit card delivers claim adjudication and payments in real time

esorse cardEsorse provides a new way of delivering electronic health and dental claims processing with real-time adjudication and payment services.

The company developed the Esorse Hybrid Pay Direct Card to help reduce the financial burden placed on families who have to pay out-of-pocket for health services. It was originally conceived for helping families with special needs and high healthcare costs, but now all plan holders are benefiting.

The first of its kind, the Esorse Hybrid Pay Direct Card provides significant benefits to patients, health care providers, employers and insurance companies.

The Esorse Hybrid Pay Direct Card eliminates paperwork and transforms the claims submission and payment process in a simple, secure and streamlined manner. Any healthcare professional, hospital, product or service provider with a computer and Point Of Sale (POS) terminal can file claims online and directly receive payment at the time of service.

The card improves plan holder satisfaction by immediately confirming coverage for services provided, while eliminating out-of-pocket expenses and avoiding the disappointment of having claims declined post service. Plan holders can also check their account balances, plan limits and more, online 24/7.

The platform also provides insurers with access to reports in virtually any format required to meet clients’ demands for more comprehensive information, while still complying with the Privacy Act. Unlike any other card system, Esorse offers a new level of flexibility by coordinating payments between insured and Administered Services Only (ASO) programs and Health Spending Accounts.

Creating a best-in-class health benefit card

Esorse designed the Hybrid Pay Direct Card from the ground up to be simple, secure and convenient. However, to deliver on its objective of automating and streamlining business processes to the benefit of patients, health care providers, employers and insurance companies, Esorse needed a prepaid partner who understood its business and was willing to interface directly with the company to make its Hybrid Pay Direct Card a reality.

A best-in-class prepaid partner had to be open to, and capable of, supporting a hybrid card that enables real-time adjudication, loading and payment of claims. The chosen partner also had to demonstrate its willingness to “work outside of the box” as the Esorse Hybrid Card is unlike most prepaid cards which have a certain amount of money pre-loaded onto the card. With Esorse, funds are only loaded onto the card when a claim has been adjudicated, providing greater financial security.

In addition, the Esorse card needed to operate on the global Visa network, since the company wanted to ensure no extra POS terminal would be required by practitioners. Finally, the prepaid partner had to be backed by the big banks in Canada and provide Esorse with a first-party connection to these financial institutions.

Berkeley the prepaid partner of choice

Berkeley delivers MasterCard and Visa prepaid card programs for corporations, governments, and financial institutions. As a trusted managed services provider, Berkeley collaborates with clients to create custom prepaid incentive and payment solutions that enable business goals to be reached simply and cost-effectively.

“Berkeley understands our business and their team was keen to work with us and do whatever was required from their end to help us successfully launch the Esorse hybrid card,” says Tony Palermo, Director of Marketing at Esorse.

The team at Berkeley Payment Solutions worked closely with the Esorse IT team to develop a highly customized system that enables Esorse to maintain its own front end. Through system-to-system integration, Berkeley ensures quick, secure and reliable access to orders, no matter how many administrators Esorse requires to process cards. This helps to keep administrative costs to a minimum.

After claims have been adjudicated in real time, Esorse program administrators interface directly with the Berkeley system to load and update cards, with Esorse-branded plastic being shipped directly from Berkeley to Esorse. In addition, Berkeley’s automated system enables Esorse to update client information, such as contact information, without having to contact Berkeley. Esorse can also pull account transactions and other reports without any intervention from Berkeley, which helps Esorse focus on its core competencies and client relationships.

“The Esorse Hybrid Pay Direct is unlike any prepaid card and requires the support of a payments outsourcing partner who shares our vision and can provide the expertise, support and infrastructure necessary to deliver this industry first, cost-effectively.”

For employers, the Esorse card features multi-function capabilities that enable it to also be used for payroll and self-insured disability payments, travel advances and reimbursements, and more.

Moving forward, Berkeley will continue to provide the agility necessary for Esorse to open up new opportunities and deliver new payments products and services in a timely and cost-effective manner. Esorse is expected to launch additional capabilities for its hybrid card, including a new mobile application.

The Benefits of Berkeley

  • Agility: Berkeley helped Esorse deliver an industry first easily and cost-effectively, while establishing a system framework that can evolve to deliver new and exciting capabilities.
  • Security: Reloadable Visa Prepaid Cards offered by Berkeley are backed by the security of brand-name financial institutions in Canada.
  • Seamless, customized integration: System-to-system integration enables Esorse to leverage its existing enterprise systems to keep costs down and focus on its core competencies.
  • Great customer service: Berkeley’s commitment to customer service and support ensures the Esorse Hybrid Pay Direct Card can deliver on its promise of claim adjudication and payment in real time.
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