Ensure services are being rendered by appropriate caregivers, that services are covered under the patient’s benefit plan and coded correctly, and that patients understand their financial responsibility. Use our Dashboard to identify problem areas,  a benchmark to peers, and monitor your success.”

Efficient and accurate tools to facilitate care.

Confirm provider eligibility, review claims for medical necessity, flag outliers, validate correct coding, bundling, and pricing. Return clear adjudication messages, and use our Dashboard to identify areas of risk, utilization trends, initiate focused audits, and develop education campaigns.

Claims done right.

Up your value to clients by making sure every claim field and a line is populated with appropriate data, potential problems are flagged for review prior to submission, and performance reports generated by our Dashboard that put a twinkle in their eye.

Comprehensive tools to keep claims flowing.

You built the system, created the interfaces, and rolled out the red carpet for clients. Now back up your service guarantee with the most robust medical necessity, coding, payment, and provider credentialing knowledge in the industry. White-labeled apps, real-time queries, or behind the scenes data access, we’ve got you covered.

You run the systems, we’ll run the data.

You came, you saw, you conquered, you’re tired. Next time, do it smarter. Automated tools for claims review and an interactive Dashboard to generate results that make a difference.

Smart, actionable restrospective claims review.