• ClaimsXten


Paying claims faster and more accurately

Increasingly complex plans plus more and varied lines of business can push healthcare payers' claims payment systems beyond their ability to deliver the necessary speed and accuracy. ClaimsXten™, a module of the McKesson Total Payment™ solution, is an advanced, flexible system that provides clinically based claims auditing quickly and accurately in a hosted environment.

ClaimsXten can apply edits to claims at any point in your workflow, so you can automate and manage the requirements for specific terms and conditions of each benefit plan – professional and facility payment and medical policies.

ClaimsXten can be delivered via a full service ASP solution securely hosted by McKesson, or customer-hosted with a customized service path.

As a module of the McKesson Total Payment™ solution, ClaimsXten also integrates with the InvestiClaim™ module on a common transaction platform to deliver an automated, full continuum approach to waste, abuse and fraud management.

Benefits

  • Increases auto-adjudication rates. According to client estimates, you can increase auto-adjudication by 2% to 4% or more by applying editing rules for your most complex payment and medical policies that were previously unable to be applied.
  • Reduces administrative costs. With a 5% increase in edit accuracy, you can avoid adjusting a portion of your claims and realize administrative savings. 1
  • Minimizes resource use. ClaimsXten can maintain all payment and medical policy rules and logic on one platform, greatly reducing your clinical and IT staff burden of policy administration.1
  • Reduces medical spend. You can save approximately 5% to 6% of annual professional and facility medical spend via our comprehensive rule library, flexible rule logic and 200+ data elements from which to build custom rules, and expert consultants that work with you to identify more areas of savings – including areas with the greatest speed to value.2
  • Extends the life of your systems. The online delivery of claims auditing services to your organization lessens the burden on your claims systems, so they will be useful longer. 

Do you want to know more about ClaimsXten or the McKesson Total Payment solution? Call us at 800.782.1334 or request more information.

1Based on administrative savings forecast performed by McKesson using client data. Actual savings results may vary by client.

2Based on benchmarked savings analysis derived from actual aggregated client data. Actual savings results may vary by client.