Single Platform, Multiple Use Cases

Deploy a single platform that enables multichannel capture, business process and dynamic case management, mobile, outbound document generation and delivery, including E-signature, information integration and analytics

Pre-Configured Solution

Validate all subscriber, patient, provider and service line data via a comprehensive rule set to ensure consistent, compliant and accurate validation of claims; capture and exception handling may easily be extended with custom steps 

Operational Analytics

Gain visibility and insight into operations using capture metrics from your medical claims forms; identify where workflow improvements are needed with dynamic dashboards and near real-time reporting

Easy Integration Across Systems

Automatically convert your ‘clean claims’ to ANSI X12–compliant EDI for handoff to your claims adjudication system; easily access or update other file formats or systems during capture, validation or after completing pre-adjudication within Claims Agility, and create essential links between our application and your systems of engagement and systems of record

Provider Portal for Review and Correction

Identify true biller errors quickly and achieve resolution faster through a collaborative exchange between the biller and your examiner; notify billers by email when their claim is rejected, and empower them to resolve the claim through a 24x7 biller portal that supports messaging, viewing of submitted documents, and submission of additional documentation or replacement claims as requested by the examiner

Simplified Handling of COB Claims 

Capture line-level or claim-level adjustments from Explanation of Benefits (EOB) or Remittance Advice (RA) documents via a facilitated interface; adjustment data is automatically validated and converted to EDI with the claim

Compliance and Risk Management 

Stay productive and current with changing regulations by implementing a solution that maintains current medical code sets and adheres to NUBC, NUCC and EDI guidelines; reduce risk by eliminating paper, controlling access to archived digital images and monitoring all user activity

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