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.
Enhance Claims Processing
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.
