TAKE FULL CONTROL OF CLAIMS.
Full-Service Claim Administration
Leverage our team and technology to get claims paid 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.
Boost member health and satisfaction with increased provider engagement. Our easy-to-use provider portal offers real time eligibility, claim status, and claim submission. It also allows online prior authorization submission and status as well as messaging to streamline the process.