Payment Accuracy Solutions
Innovative, end-to-end payment accuracy product suite for payers that want to improve claims adjudication and streamline payment operations across all payment modalities.
Our tools use an innovative analytics engine and robust messaging platform to provide messaging back to the provider at the time of claim submission. This integrated process reduces losses for high-volume, low-dollar claims; decreases overbillings; and changes outlier behavior.
Our partners can increase their audit savings and improve their medical cost savings with no additional risk.
80.1% outlying providers exhibit more accurate billing and >$210M in total savings
Claims management is one of the most critical aspects of medical cost savings for a health plan. Our industry-leading clinical and payment management product, ClaimsXten, uses advanced rules and clinically sourced edits to enable payment innovation and drive medical and administrative savings. ClaimsXten is interoperable with a variety of claims processing systems.
ClaimsXten can help you:
Savings rate averages 3-8% of total paid dollars