Software
Advanced Claim Management
An advanced claiming solution for payers that want to improve claim auto-adjudication rates and identify the most efficient path to process claims for a higher first-pass rate and lower costs.
EnhanceClaims Processing
- Significantly improve processing cost-per-claim by reducing manual intervention in the claim re-pricing and/or adjudication process.
- Support tangential claim adjudication processes with the ability to provide supplemental data.
- Identify the most efficient path for healthcare claims to be delivered to the final claim adjudicator.
- Reduce the time spent working pended claims with the ability to filter or reject transactions based on customer reference data.
- Appropriately direct pre-adjudicated claims to/from PPO partners for repricing services prior to delivering to a customer for final adjudication.
- Improve accuracy by validating, augmenting, replacing, and normalizing provider submitted data.
Improve Claim Auto-Adjudication Rates
Our outcomes
PRODUCT SUPPORT
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