We are helping plans to manage the claims inventory and maintain the effective first pass rate, QNXT support capabilities include:
- Medical and dental claims processing
- Manual Claims re-pricing
- Capitation/risk fund management
- Hospital and medical pre-authorization
- Case Management
- Implementation Assessments & Strategy
- Project Planning & Management
- Business Analysis / Requirements Definition
- Process Design & Improvement
- Customer service support
- Premium billing support and customized reporting
- Provider Network Management including minimizing the provider data load issues
- Group/membership administration support
- Referral management
- Workflow Implementation
- Claims Analysis, Payment Validation and Backlog Reduction
- QA & Testing for QNXT migration and Implementation
- Clinical Consulting / Care Management
- Customized QNXT™ User Training
- Post-Implementation Audits
- Electronic data interchange
Addiox have the technical and functional specialization in all of the following modules:
- Benefits & Contracts
- Subscriber / Member
- QNXT™ Case Management
- Accounting, Billing & Commissions
- QNXT™ Accounts Receivable
- Capitation
- Prior Authorization
- Provider
- Plan / Products
- Business Rules and Workflow
- Claims
- Customer Service
- QNXT™ ITS (Interplan Teleprocessing System)
- QNXT™ Dental