Sharpen your claims processing with automation and advanced analytics

Medical billing mistakes result in heavy dollar losses for healthcare payers, and the 'pay and chase' strategy no longer works. Robust revenue cycle management begins with reducing operational and medical expenses, with a special focus on identifying leaks and plugging them immediately. Payers need a cutting-edge solution that can not only identify but also predict errors and overpayments using the data at their disposal. An advanced analytics solution can finetune its precision over time and improve savings in terms of overpayment avoidance year-on-year.

FEATURES

Get Automatic Bang for your Buck

The ApexClaims platform is characterized by a synergy between advanced technology like the cloud, processes that aim for precision every time, and a team of experts adept at building tailor-made claims analysis solutions for payers

Claims Administration

Let AI-backed insights show you how to create breakthrough improvements in pre- and post-payment processes. Manual touch reduction helps you do it right the first time, while claims processing and audit builds better compliance

Member Management

Drive your member management systems easily and efficiently with automation. Push for higher star ratings, increase member satisfaction and maximize enrollment

Provider Network Management

Manage your network of impaneled providers at scale with credentialing services, contracting, and improved process tracking and reporting through automation

Risk Coding

Leverage machine learning models to identify risks and adjust according to Hierarchical Condition Category (HCC), which assesses expected medical costs based on a proven scoring system

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