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Mining Detailed Claims Information
McKesson medical claims management solutions include ClaimsXten™, which helps payors implement and manage their full spectrum of claims payment policies. Delivered via a full-service ASP model, the solution provides the speed and flexibility to address payors' constantly changing business requirements.
ClaimsXten uses specific criteria to foster decisions that ensure payment policies are aligned with product design, provider contracting and medical policies.
Delivering Wide-Ranging Benefits
- Increases clinical and administrative savings through the effective and targeted application of up-to-date claim review protocols
- Applies payment policies consistently and transparently
- Reduces manual interventions, which in turn cuts down on claims turnaround times
- Adds flexible rules creation and rules firing to meet payors' specific and unique requirements
- Reduces claims processing system burden
Providing Flexibility to Increase Efficiency
ClaimsXten provides flexibility by applying edits to claims at any point in the workflow; this allows for the expression of unique requirements pertaining to various physician contracts, claims management policies and medical payment policies.
With ClaimsXten, payors have the ability to:
- Increase their auto adjudication rates
- Augment medical and administrative savings
- Improve processes to consistently and accurately apply their policies
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