Claims Processing

Solution

Claims Processing

Automated data management for efficient claims processing
  • Omni-channel claims ingestion
  • Automated high-volume data capture and routing
  • Clean claims for efficient processing
  • Reduced resubmission and follow up

Overview

Upgrade your claims processing by unifying data from all incoming communication channels, performing pre-submission checks to create clean claims, and intelligently routing claims for optimal processing using systems capable of intelligent decisioning.

 

Comprehensive business intelligence reports with customized output files allow full visibility over the claims management process.

Features
Universal Gateway

Capture claims at the point of service, from any channel, with translation to location-based language. Ensure the most accurate and efficient compliance and payment processing services, using intelligent intake, extraction, and data enhancement tools.

Appeals & Denials Management

Set and apply business rules to produce clean claims, reduce resubmission and follow up, decrease denials and rejections, and reduce print, mail, and call volumes.

Intelligent Decisioning

Relevancy tools automatically route documents and claims for appropriate reconciliation. Comprehensive review process reduces claims processing and spend leakage.

Efficient Processing

Exela’s claims processing system helps Improve accuracy, lower costs, reduce resubmissions, strengthen payment integrity, and identify underpaid claims to assist with recovery.

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Case Study

Claims Processing Automation

Exela’s PCH platform enables automated claims processing for a top 10 healthcare payer
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