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Our mission is to provide a cost effective and comprehensive claims payment solution that integrates with our client's and provider's processes.

   

Eligibility

Management

 
  • Ensure Accurate Coordination of Benefits.
  • Monitor FMLA and COBRA Status.
  • Identify Advocacy Candidates.
  • Establish and Monitor Subrogation Cases.
  • Identify Potential Third Party Payers.
  • Confidentiality of all member's personal data.

Claims Processing and

Auditing

 
  • Accurate auditing and efficient claims payment.
  • Medical review and auditing by licensed RNs.
  • OFAC and FDR compliant payments.
  • Ensure Coverage of Services Rendered.
  • Negotiating leverage through direct claims payment.

Claim

Reporting

   
  • Claims data analysis and communication with client through accurate reporting.
  • Facility claims management and communication with the Provider Contracting team.
  • Financial management and reporting over the continuum of claims payment.