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.
Significantly improve processing cost-per-claim by reducing manual intervention in the claim re-pricing and/or adjudication process.
Reduce the time spent working pended claims with the ability to filter or reject transactions based on customer reference data.
Support tangential claim adjudication processes with the ability to provide supplemental data.
Appropriately direct pre-adjudicated claims to/from PPO partners for repricing services prior to delivering to a customer for final adjudication.
Identify the most efficient path for healthcare claims to be delivered to the final claim adjudicator.
Improve accuracy by validating, augmenting, replacing, and normalizing provider submitted data.
Reduce Transaction Costs and Enable Faster Payments with Medical EDI Network
Learn how the size and capabilities of our Medical EDI Network can help you optimize your revenue cycle.
Boost Efficiency and Cost Savings with Electronic Claims Processes
Learn how electronic Claiming & Remittance can help streamline processes, reduce costs, and improve provider satisfaction.
Get Real-Time Eligibility and Benefits Verifications
Learn how access to real-time eligibility and benefits verification facilitates clean-claims, benefiting both providers and payers.