For Payers

Payer - Delivery Expertise

Claim Management

• Claims Administration, Quality Check, Suspense Release, Mass Adjustment, Void Replacement
• Process Claim Requests, Claims Adjudication, Third Party Liability, Final Payment Calculation
• Client Assessment, Facilitation Planning, Service Purchase, Case

Regulatory & Compliance

• TriZetto, Facets and QNXT
• HIPAA / IC10 / CMS / MITA / CAHQ

 

Claim Management

• Claims Administration, Quality Check, Suspense Release, Mass Adjustment, Void Replacement
• Process Claim Requests, Claims Adjudication, Third Party Liability, Final Payment Calculation
• Client Assessment, Facilitation Planning, Service Purchase, Case

Regulatory & Compliance

• TriZetto, Facets and QNXT
• HIPAA / IC10 / CMS / MITA / CAHQ

 

Patient Centered Connected Care

• Wellness Management
• Disease Management

Eligibility & Enrollment

• Member Eligibility & Relationship Check
• Coordination of Benefits
• Workflow dashboard
• HIPAA Complaint
• Secure & Encrypted

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