Expedited claims. Multiple interfaces sync with your corporate brand. Digitized data environment that can be accessed from anywhere, at any time. Health and Life processing via faster systems that aligns with your processing needs.
Speeding up the claims life cycle to match the influx of your claims—while reconciling and resolving the more complicated claims at record velocity.
It’s in. It’s out. No interruptions or claims processing delays. CLAIMSplus moves claims faster, working with employers, TPAs and insurers with robust in-the-cloud processing platforms.
CLAIMSplusis in the business of optimizing processes and expediting medical claims through secure, reliable and efficient electronic claims management.
More to the point, our technology—first and foremost—manages claims quickly and efficiently. We’ve asked our clients, and the timescale of the claim is the most important element for claims processing. For this, a single platform seamlessly feeds into client and provider systems. This translates into claims processing triaging that gets it right each and every time. By using a single platform, CLAIMSplus provides distinctive claim strategies for our individual clients since no two insurers are the same. We layer new technologies alongside claim automation. Among so many other benefits, by enlisting our claims processing services, CLAIMSplus permits payers to release on-site skilled claims professionals to work on less time-consuming activities. CLAIMSplus technologies overlay new datasets with claims data, thereby offering a wide array of claims solutions and approaches. We select what works best for each of our clients, no matter their company sizes. Our cloud integration platform enhances connections between on-site and cloud environments, with interfacing applications that yield platform connectivity and compatibility with other systems.
A rejected claim may be caused by a clerical error, or it may come down to inaccurate procedure and ICD codes. CLAIMSplus avoids rejected claims by scrubbing, resulting in a clean claim. Time-consuming and costly resubmissions and appeals are pure headaches, so CLAIMSplus gets it right the first time by automated system alerts, thus pushing aside –literally—incompatible procedure codes and visit claims and replacing them with the right data that aligns with patient coverages.
TPAs and Healthcare Payers realize greater return on investment by enlisting our modern core claims processing system as their go-to technology foundation. A scalable and flexible payer platform, CLAIMSplus takes into account your current operational and technical needs. By this we don’t mean one size fits all. We understand that you may need support for multiple lines of business, but that each business is unique. Each client is distinctive.
We fully realize the treacherous environment for which we live, and it’s never been more important to protect mission-critical data such as personal information and healthcare-related electronic data. CLAIMSplus leverages powerful preventative measures in order to protect sensitive information from being stolen, compromised, or hacked. Our programmers and systems analysts understand the seriousness of potential cyberattacks as well as viruses and other malicious code. CLAIMSplus enlists resilient cyber-protection strategies such as risk management, identity management and incident management, to name a few. In addition, we incorporate the following measures in order to safeguard your precious data from detrimentalattacks:
Managing costs is paramount. Healthcare payers and third-party administrators don’t want to bust anyone’s budget any more than do we. CLAIMSplus delivers robust and strategic claims processing models that rein in costs and save operational dollars. Our reimbursement configurations and automated late-payment fees drive everyone’s costs down. Automated repricing tools and other advanced algorithms work to reduce claims processing costs with overarching outcomes you will only experience by partnering with CLAIMSplus.
Smart Business Intelligence (BI) translates into smarter processing so payers can recover significant savings. Formidable benefit calculations are automated with such regularity thatwe may even make it look easy. Complete with automated audits, real-time built-in alerts, membership and eligibility management tools, CLAIMSplus saves our clients’ budgets in a variety of ways.Auto-adjudication and accurate coding tools help you contain costs with affordable and intuitive administrative processing technologies that meet most budgets. Rules-based configurations are electronically automated, including late payments as well as interest calculations. Customized EOB codes allowsuch actions as deny, pend and approve. With CLAIMSplus, we can auto-generate AR and AP transactions,thus yielding additional ways to save operational and claims management costs.