Claims Adjudication

We offer a comprehensive Claims Processing and Adjudication Software built for Health Plans

Get Claims Adjudication Brochure

Product Features

Manage Claims

Manage different queues based on the status of the claim

Member Management

Explore member profile, subscriptions and claims history

Paper claims billing

Manage and bill your paper claims

Track Claims

Track the status of the claim from intake to payment acknowledgement

Segregation of Claims

Segregate claims by FSS and CAP based, or based on place of service

Provider Contract Management

View provider contracts with their compensation rules and exceptions

1

Payor Review

2

Translate EDI files

3

Claims view in CMS form

4

Payment Decision Making

5

Claims Batching

6

Authorization of Maintenance

Insights on Claims Adjudication

Related Services