Comprehensive bill adjudication for group health plans — proven to reduce employer costs by 25%. The ideal solution for self-insured groups of any size, with full HSA/HRA account tracking and seamless CDHP integration.
Comprehensive bill adjudication that reprices claims to any fee schedule or provider panel. Combines all the advantages of our proven workers' comp system with group health-specific features. Enables administrators to view all claims — workers' comp, STD/LTD, P&L and group health — on one unified system.
Automatically tracks HSA, HRA, and employer-defined trust accounts with virtual accounts to cover insured deductible components.
The final solution for Consumer Driven Health Plans — eliminates the usual medical provider and employer workflow of processing claims.
Especially designed for self-insured employers of any size. Can cut employer costs by 25% through automation and efficiency.
Comprehensive bill adjudication reprices to any fee schedule or provider panel with clinical edits and PPO savings.
Process Group Health alongside Short-Term and Long-Term Disability claims on the same unified platform.
Combined with QuickPayNET® obtains substantial discounts from hospitals and providers with Point-of-Service adjudication.
Integrated medical case management and utilization review — the same powerful tools used in workers' comp.
Enables administrators to view all claims of an insured — workers' comp, STD/LTD, P&L, and group health — on one system.
Proven technology trusted by employers, TPAs, and MCOs nationwide.
18+ years of continuous web-based operations with industry-leading reliability.
Proven to reduce claims processing costs through automation and efficiency.
Enterprise-grade technology backed by IBM partnership and infrastructure.
Full compliance with healthcare privacy and security regulations.
Join employers, TPAs, and MCOs nationwide who trust Claims Advantage™ for their group health claims management.
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