The marketplace for health plans and payers is exceedingly competitive and realizing cost-savings wherever you can is imperative. Instituting and maintaining an internal data center to process medical claims is rarely time or cost-effective for either new or established payers.

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RelayHealth's Managed Care Optimizerâ„¢ (MCO) solution has supported Managed Long Term Care, Medicaid, Medicare and Fully-Integrated Dual Advantage (FIDA) payers in the medical claims market for more than a decade. MCO's hosted application combined with fully outsourced medical claims processing provides the same functionality as an on-premise processing center, with the added benefit of a predictable monthly expense. This helps to reduce your operating costs, as you are only paying for medical claims processed each month instead of funding the maintenance of an internal data center.

Dedicated medical claims processing support that knows your business

Our full-time, experienced team of claims processing professionals is dedicated to ensuring that your claims are processed accurately and quickly and that all customers experience superior customer service. MCO can be deployed within your organization, depending on the size, in as little as three weeks with minimal resources needed from your team.

Features of Managed Care Optimizer:
  • Provides dual-eligibility services
  • Includes encounter data processing services (EDPS)
  • Optimized to address unique requirements of behavioral health plan designs
  • Highly efficient, experienced claims processing professionals
  • Automated electronic payments to providers directly from patient's health savings account
  • Rapid implementation of services so claims can be processed almost immediately
We can help:
  • Drive lower cost of ownership through predictable monthly fees
  • Eliminate cost of building and supporting a claims processing center
  • Improve cash flow