Provides a single connection point for transactions, helping enable industry standard and payer-specific business rules and compliance with legislative mandates.
Simplifies the claims administration process, consolidating submitters and reducing administrative complexity so it’s easier for providers and payers to work together.
Improves claims routing accuracy and reduces claim rework. With the ability to route transaction data to the appropriate processing path, you can simplify transactional workflows - even one with multiple claims systems and lines of business.
Advanced claims edits and routing
Applies advanced claims edits and presents edit errors directly to submitters to catch errors up-front in processing so claims can be made cleaner when routed for processing.
Simplifies compliance with federal regulations, HIPAA, and CORE Phase I, II and III for ACA Operating Rules.
Reduces administrative waste stemming from low first-pass rates and claim rework due to incorrect routing across multiple adjudication systems.