Managed Services for Medical Claims Processing

ClaimsCapture brings payers into the future of claims processing.

Its quick and accurate workflow keeps users focused on business priorities and scales smoothly as operations grow.

Still, it sometimes makes sense to keep claims processing outside of their walls.

Until now, automated and managed claims processing have been mutually exclusive. Outsourcing is nothing new, but still relies on manual effort with its typical problems of accuracy and scalability. There has not been a claims processing solution that is totally external and benefits from an efficient, accurate, technology-enabled workflow.

The ClaimsCapture Managed Service Difference

We understand that claims processing is one of many moving parts for a typical payer. Our software automates it rapidly, but that process may have inputs and outputs that need a different strategy.

For instance, this may occur when:

  • The org has matured around a BPO-centric model that would be too disruptive to overhaul
  • Claims processing is a totally new responsibility that cannot happen in-house for various financial, operational, or strategic reasons
  • Claims are one of many document types handled through similar workflows; any solution that addresses one must addresses all

In response, we have forged a managed service partnership that combines the ClaimsCapture platform with global, end-to-end resources spanning mailroom management to claims adjudication and everything in between.

100s of Payers, 6 Continents, 1 BPO Solution

Clients across the globe receive the same industry-leading workflow management and expertise at every step in the revenue cycle.

From mailroom operations to final EDI output to revenue cycle management, our managed-service partner has served over 52 million lives via:

  • 9 of the 10 largest Medicare plans
  • State and national healthcare agencies
  • The majority of America’s largest providers and laboratories
  • State and federal healthcare agencies, including CMS

Through our managed claims processing service, payers of all sizes have world-class and worldwide support for their most essential data and documents.

Please reach out to learn more about hands-off claims processing, and the innovative team and tools behind it.