142   M
Insurance documents processed annually
12 M  +
Adjudication annually
22  
Top US payers rely on Exela
700 K 
Claims processed daily

What we offer

Exela Healthcare delivers a complete portfolio of technology-enabled solutions that support the entire spectrum of back-office processes used by healthcare insurers.

From enrollment and claims processing to full adjudication and reimbursement integrity, Exela offers automated, secure, and streamlined processes designed to deliver exceptional financial accuracy and less re-processing, while also reducing costs significantly.

How We Can Help

Member Enrollment Services & Healthcare Exchanges

Quote to card

Secure, web-based platform for effectively managing healthcare enrollments and documentation

Member installation

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Health Line

Nurse guidance and advice

Appointment Scheduling App

Scheduling appointments

Insurance verification

Dashboard analytics: view by provider/facility/date 

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Provider Data Management

Credentialing

Contract management

Installation

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Claim Submitted via PCH Global™

Accomodate large volumes of claims electronically or via mailroom

Single channel for paper and EDI

Mailroom: sorting, scanning, data capture

Data verified and pre-claim edits → clean claim

Real-time notification and visibility of any deficiencies and status of claim

Client-specific validation

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Adjudication

Clean claims

Business rules integration | pre-edits | authorization

Contract fee schedule

Remittance/payment

Explanation of benefits/liabilities mailed

Exception management

ePresentment of denials

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Claims Audit Services

Nurse review

Customized compliance audits

Consistent rule updates

Claim checked against contract database for optimal billing

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Payer Payments

Paper or electronic transactions, and lockbox (BancHub)

Manage reports

Adjustment

Daily deposit log

ERA conversion

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Revenue Integrity

Overpayment identification and recovery

Dashboards and solutions-driven reports using big data analytics

Predictive analytics

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Call Center Support

Claims-related inbound and outbound call center support with 24/7 coverage

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Storage, Archival & Retrieval

On-premise and/or cloud-hosted

Security and compliance

Amendment tracking

Summarization and dashboards

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Unified Communications Services

Live or virtual agent

Patient outreach and disease management

FAQ

EOB correspondence: print and mail

Billing automation (payment by IVR)

Scheduling and support

Mobile apps

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Accounts receivable management, Debt Collection

Pre-delinquency, third party debt, and legal collections

Credit reporting

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Read what our customers have to say

See how our customers are using Exela products and services to improve their business

Customer stories

Get in touch with our sales team

Call us today to discover how Exela can support your success with platform-driven business process solutions

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