Managed Care Optimizer: Medical Claims Processing for Health Plans

Efficient, accurate medical claims processing and a predictable monthly expense.

In the highly competitive health marketplace, you need to cut costs wherever you can. But maintaining an internal data center for claims processing eats up incredible amounts of time and money. Managed Care Optimizer™ (MCO) solution has supported Managed Long Term Care, Medicaid, Medicare and Fully Integrated Duals Advantage (FIDA) payers in the medical claims market for more than a decade.


Put the power of an on-site claims processing center to work for you

Combined with fully outsourced medical claims processing, MCO’s hosted application provides the same functionality as an on-site processing center. Plus, it offers the benefit of a predictable monthly expense. This feature reduces your operating costs, since you only pay the medical claims processed each month, as opposed to funding internal data-center maintenance.

Medical claims processing support that knows your business

All claims are handled quickly and accurately by our full-time, experienced team of claims processing professionals. You can deploy MCO within your organization, depending on size, in as little as three weeks with minimal resources from your team.

Managed Care Optimizer aids health plan optimization:

  • Drives a lower cost of ownership through predictable monthly fees
  • Eliminates the cost of building and supporting a claims processing center
  • Improves cash flow

Managed Care Optimizer features include:

  • Dual-eligibility services
  • Encounter data processing services (EDPS)
  • Optimization for addressing the 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
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