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