Achieve the Next Level of Claims Auditing

Accurate and efficient claims payment is a core requirement for your business, but claims management and adjudication are complex processes governed by frequently changing business issues and payment regulations. Your claims auditing solution now must also deliver customization capabilities and precision to match your diverse claim types and auditing criteria.

ClaimCheck® Plus is our clinically-based claims auditing solution that helps you automatically:
  • Manage your unique, proprietary and complex auditing requirements
  • Manage compliance with state and provider mandates
  • Identify and gain control over outpatient facility billing errors

ClaimCheck Plus includes all the claims auditing software and knowledge bases-and the on-site self service features-of ClaimCheck.

In addition, it offers tools for easier configurations that can be performed by business analysts and similar staff members. Further, ClaimCheck Plus allows you to control definition of specific rules and criteria to reflect your plans' medical policies, enabling payments that match your criteria all the way to the edit details.

With ClaimCheck Plus you also gain enhanced modifier auditing, for more accurate claim audits that align with payment mandates and thus improve your stakeholders' satisfaction.

Benefits

  • Closer alignment of medical policies and claims auditing criteria
  • Fewer payments that don't match your medical policies
  • Increased consistency and customization flexibility
  • Reduced dependencies on IT resources