Healthcare Payer
  • Claims Administration, Quality Check, Suspense Release, Mass Adjustment, Void Replacement.
  • Process Claim requests (EDI and Paper), Claims Adjudication, Third Party Liability, Final Payment Calculation
  • Client Assessment, Facilitation Planning, Service Purchase, Case Management control and Monitoring
  • Payer and Provider Notification
  • Enrollment of Providers and Patients.
  • Member Eligibility & Relationship Check
  • Provider Eligibility
  • Coordination of Benefits
  • Member Appointment Scheduling
  • Notifications, Alerts
  • Utilization review, Exception Control
  • Workflow Dashboards
  • HIPAA Complaint
  • Secure & Encrypted
  • Full end-to-end capabilities on Trizetto, Facets and QNXT
  • Retention
  • Experience
  • Engagement
  • Technology Services
  • Patient
  • Population
  • Claims Analytics
  • Big Data Analytics
  • Wellness Management
  • Disease Management
  • IC10
  • CMS
  • MITA
  • CAHQ