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GTESS Announces Claims Processing Solutions for Private Healthcare Systems' Customers

GTESS Offers Technology Solutions to Support Rapid Conversion to the PHCS e-price Automated Claims Repricing Service

November 16, 2005 (Richardson,TX) GTESS Corp., a provider of technology-based claims processing services to the healthcare industry, announced today it entered an agreement with Private Healthcare Systems (PHCS), the nation’s leading health care cost management company.  GTESS will offer a menu of claim processing solutions to PHCS customers converting to PHCS e-price, an automated claims repricing service.
 
PHCS e-price was introduced in 2001 to help health care purchasers address the inefficiencies and additional costs attributed to traditional claims repricing methods. As an automated claims repricing service, PHCS e-price uses the latest technologies to streamline repricing operations, minimize processing errors and improve the accuracy and efficiency of claims operations.  By the end of the year, all of Private Healthcare Systems’ customers will use PHCS e-price for timelier, more accurate claims data.   
 
Through its relationship with Private Healthcare Systems, GTESS will offer a competitively priced technology solutions package designed to provide current and prospective PHCS customers with a quick transition to 100% electronic claims connectivity with PHCS e-price. By integrating GTESS and PHCS technologies, payers can quickly take advantage of lower operating costs, increased claims accuracy, and the elimination of burdensome and resource intensive fee schedule administration.
 
“We know establishing EDI connectivity presents significant challenges for most companies,” said GTESS CEO and President, Deborah M. Gage. “With GTESS proprietary technology and our established connectivity across the industry, we can offer customizable solutions to PHCS customers for quick, effective PHCS e-price implementation and broader EDI connectivity.”
 
“GTESS has a proven track record of understanding and meeting the technology needs of the health care industry through value-added claims solutions,” said Frank Jackson, PHCS Chief Information Officer. “Our relationship with GTESS enables us to proactively offer our customers a complementary claims processing solution to promote the rapid and smooth transition to PHCS e-price.”
 
Working with GTESS and its comprehensive offering of customizable solutions, PHCS customers can enhance their EDI connectivity, quickly convert to PHCS e-price and reap the benefits of advanced integrated technologies to improve their operations and reduce their costs. GTESS can also provide additional value for PHCS customers who utilize the GTESS eClaims Gateway™, CleanClaim™ Technologies, PPO Connect™, G-Queue™ and DocControl™ solution suite.
 
About Private Healthcare Systems
 
For 20 years, Private Healthcare Systems has been meeting the network and care management needs of customers across the country. Corporate headquarters are in Waltham, Massachusetts, with regional offices located throughout the United States. PHCS is the second largest care management company in the country as well as the largest national proprietary PPO. The PHCS Network includes nearly 450,000 providers and more than 4,000 facilities. PHCS is the first and only national PPO to earn four endorsements of quality from two independent, nationally recognized quality assurance organizations, NCQA and URAC.
 
About GTESS Corporation
 
GTESS Corporation provides customers with a total pre-adjudication medical claims processing solution called the Claims Gateway Solution – a single portal access to a suite of five integrated, client-customized software modules for EDI receipt, data conversion, claim cleaning, network management / repricing, claim edit resolution and document management. 
 
The Claims Gateway Solution uses business process management (BPM) technologies to create new efficiencies and offer process transparency throughout the claim process. Our ‘clean-claim’ HIPAA-compliant electronic data interchange (EDI) delivery systems go beyond what can be achieved by automating parts of the process, or outsourcing operations off-shore.  For more information please visit www.GTESS.com.

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Ellen Donahue-Dalton
GTESS
404.442.7900

Christine Martiny
PHCS
781.895.6804