Claims Flow & Routing
Through our strategic partnerships, we streamline the process of getting your claims directly from the source to one or multiple destinations, ensuring swift handling and thorough review before returning them to you for a final assessment.
Repricing
By employing a hybrid strategy that combines cost containment measures with Intelligent Automation, we ensure that every claim is efficiently guided toward optimal savings.
Review
Claims undergo meticulous review, auditing, and refinement, focusing on key factors such as accuracy, cost, coding integrity, bundling / unbundling, DRG/APC compliance, and adherence to NCCI edits.
Pricing Assurance & Specialty Products
We excel in maximizing cost savings for our clients by efficiently managing the most significant expenses associated with high-cost claims.
Claim Cost Containment Platform
We offer an advanced platform designed to support you and your team in effectively managing cost containment initiatives for your groups and members.
Provider Web
We foster partnerships with healthcare providers to ensure that our members feel confident exploring options beyond their primary network when necessary, prioritizing their safety and peace of mind.