The Problem: Administrative Waste

System inefficiencies, billing errors and payment waste all contribute to a growing healthcare problem. With some $210 billion in potential losses annually, we need a quick, efficient solution to stop administrative and processing waste. Our real-time rules engine defines efficiency, processing single and batch claims in sub-second time. We also believe that our open-sourced edits foster clear communication lines between you and your providers to further improve efficiency, and reduce your rising exposure to waste.
 

The Solution: PhysicianClaim Insight

Features

  •  Audit claims in real-time, batch mode or retrospectively
  • Process claims against entire patient history in sub-seconds
  • Customize rules engine for individual payment requirements
  • Fully transparent open-source and specialty-sourced edits
  • Efficient and cost-effective SaaS-based architecture
  • Appeals support and response from clinical experts


Benefits

  • Improve auto-adjudication rates
  • Eliminate maintenance/testing of rule updates
  • Promote payer and provider transparency 
  • Increase claims payment accuracy rates
  • Integrate seamlessly with your existing editors
  • Decrease frequency of false-positives

Next Steps

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