Leverage our team and technology to reimburse providers electronically or via paper check. Our software tracks receipt of claims, processes claims based on contract terms or appropriate CMS Fee schedules, and delivers detailed claims reports (aging and turnaround time). Our claims analysts with coding certifications (CPC, RHIT) can customize at the plan and group level including fee schedules and map service codes to appropriate diagnosis/CPT codes to ensure accurate pricing and reporting, and conduct outreach for supporting documentation when needed. We will also handle all appeals & grievances.

You can access our Utilization Management system that will properly track and document all requests, ensure all documentation required to make a determination is received allowing your team to outreach for any additional needed documentation, and route requests to the appropriate reviewer. Or you can use the UM platform of your choice and transfer information to our claims team for proper payment.