Integrated, Client-Custom Technology

As a suite of integrated, client-customized software applications, ClaimPRECISETM automates three key stages of processing to complete data conversion, claim cleaning, and claim edit resolution with minimal human intervention, while providing transparent integration of data back to the client environment.

Extract

  • Data Receipt & Extraction
  • Image Pre-processing Subsystem
  • Forms Classification

Enhance

Integrate

  • Customized System Integration Layer
  • Secure HIPAA-compliant EDI Transmissions
  • File Transmission Acknowledgements

We have experience working with numerous client-built claim systems including mainframe applications as well as the following commercial systems:

  • Advantech
  • AMISYS Advance
  • Benesys
  • FACTS
  • Diamond
  • EHDL
  • HEALTHpac
  • Facets
  • GBAS
  • IDX
  • Genelco
  • HEALTHsuite
  • LuminX
  • RIMS/Qiclink
  • V3
  • Wonderbox Enterprise System

ClaimPRECISETM features:

  • Accepts paper, image or electronic form (EDI) medical and dental claims
  • Specialized software tools that quickly and efficiently extract data
  • Data conversion with advanced business rules and reasonability edits to ensure processing accuracy while improving adjudication rates
  • Unique learning technologies that deliver continual, consistent quality, backed by up to a 99.5% accuracy guarantee
  • Cleansed data formatted to client specific adjudication system requirements