PROGRAMS, SERVICES and DEVELOPMENT
ClaimEDIx © was incorporated in 2004 for the
purpose of developing enterprise class software programs and solutions for the
managed care community.
Through extensive research and hands on experience with our managed care
organization partners, ClaimEDIx identified the following challenges that
adversely impact the daily administration of managed health care and claims
processes.
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Managing multiple networks PPO, EPO, HMO, Worker’s Compensation
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Managing multiple products and fees for services
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Billing and payment tracking
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Billing PM/PM, % of savings, per transaction, flat fees for services
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Accommodating multiple disparate fee schedules for a single provider
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Accommodating provider’s that desire to “opt out” of participation with a
client, payer, carrier, broker
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Relating claim submission to a participating provider, product, network, fee
schedule, group, payer, and patient
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Identifying and correcting incomplete/inaccurate claims
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Conversion of paper claims to electronic claims
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Imaging, archiving and retrieval of claims and pertinent data for analysis
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Maximizing auto-repricing
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Compliance with Federal HIPAA EDI transaction requirements
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Centralizing all data accessed by all departments (claims, accounting, customer
service, sales, and management)
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Reporting the efficacy of the network(s) operations to clients, payers,
brokers, stop loss carriers, and providers
With our more than 30 network partner’s input, we have developed products to
meet these challenges, increase productivity and decrease the cost of
administering a managed care organization.
In addition, our team of highly qualified solution developers can analyze,
design and deliver custom solutions in any environment including web,
client-server or n-tier.
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CONTACT US
ClaimEDIx ©
9229 Ward Parkway, Suite 300
Kansas City, Missouri 64114
Voice: 816-285-5420 | Fax: 816-523-1098
Hours: Mon-Fri - 8AM-4:30PM (CST)
Email: info@claimEDIx.com
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