| With strong focus on business value and powered by a domain-focused, technically competent team, we offer comprehensive services and solutions that cover eligibility and enrollment, billing and accounts receivables, membership administration & management, claims administration & management, reimbursement & accounts payable, claims audit & fraud detection in the insurance business. |
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Claims Solutions
- Claims processing
- Claims auto-adjudication
- High-value claims review systems
- Claims audit and fraud management
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Corporate Clinical Data Management
- Admit and discharge systems
- Provider group partnership programs
- Corporate disease management
- Health element data information set
- Health information systems
- Member medical history
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Case Management Systems
- Electronic claim system interface
- Referral/authorization interface
- Medical review tracking
- Patient/provider letters
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Referral/ Authorization
- Plan and member database integration
- Web-enabled systems request
- Referral printing and access
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Inquiry Systems
- Provider and account eligibility access
- Provider claim access
- Patient status systems
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Sales and Agency Management
- Agency management systems
- Agency commission systems
- Eligibility and enrollment systems
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Financial Systems
- Loss reporting and management
- Accounts payable and receivables
- Billing systems
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About Us
