Payment Integrity for Client-Focused TPAs
Accuracy & Savings for Plans & Members
With ClaimIntelligence, TPAs across the country are doing right by their customers and their bottom line. Forward-thinking TPAs generate more revenue and win new business by using the ClaimIntelligence platform to review 100% of claims prior to their clients' payment.
In short, the client plans save 5%-15% on claims and TPAs net new revenue of $3+ PEPM.
TPAs white-label ClaimIntelligence to review every claim, regardless of size, for six unique categories of errors, each comprising thousands of edits and industry-standard rules.
Offer your clients more than standard high-dollar bill reviews
Seamlessly integrate with your existing adjudication flow
Each claim is electronically reviewed in real-time so payment timelines are never affected.
Customize what ClaimIntelligence looks for
Select exactly which edits and filters are applied to claims, to ensure you're both improving the current review process and remaining compliant with network agreements.