Claims Editing Platform
Evaluate claims for coding accuracy and integrate with claims workflow processing in real time, without human intervention.
Coding/Clinical Error Identification
Validate claims data using the platform and clinical analyst to identify inconsistent or incorrectly coded claims.
Consulting & Integration
Provide subject matter expertise support to streamline operations, adopt new technologies and grow your business.
Coordination of Benefits
Streamline recovery for commercial and government plans by using a 360-degree member review and innovative combination of unique algorithms and information from non-conventional data sources.
Review paid claims files and apply data mining/grouping logic/algorithms to identify potential overpayments and provide insights into disbursement leakages.
Identify and coordinate primary payment of claims to prevent or reduce payment/overpayment.