CLAIMEYE - PAYER SELECT

We Live In a Digital Age. It's Time To Quit Using Paper Claims.

 Current out-of-network processes are costly, inefficient, and burdensome on all parties. They are  constantly exposed to human error, resulting in delays and often incorrect claims adjudications.

With CLAIMEYE's solutions you are effectively disrupting outdated processes resulting in more cost savings, digital claim submittals, and satisfied members.

CLAIMEYE'S PAYER SELECT

  • Eliminate paper-work

  • Increased member engagement

  • Streamlined OON claim processing 

  • No paper to EDI conversion

  • Lower rejection rate

  • Reduce operational stress

  • Engagement with non-par providers through a referral tool, connecting members with health plans (through providers) with the potential to attract providers to join the network.

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SECURED WEB PORTAL FOR PAYERS AND PROVIDERS

  • Upload and publish information; monitor, submit, and adjudicate claims.

  • Single machine-readable digital file containing standard charges for all items and service.

  • Establish, update, and make public a list of all standard charges for all items and services online

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SECURED MOBILE APP FOR PATIENTS

  • Mobile app for reference in point-of-services by a patients and providers, for providers on the Edge such as in Tele-medicine settings, and patients with claim reimbursement challenges.

  • Free access to a directory of covered healthcare providers and negotiated service rates that a health care beneficiary can access and schedule in advance.

VALUABLE DATA FOR PAYERS

  • Description of each service provided by the covered providers.

  • Gross charge that applies to each individual item or service.

  • Payer-specific negotiated charge that applies to each item or service when provided.

  • De-identified maximum negotiated charge that applies to each item or service when provided.

  • Discounted cash price that applies to each item or service when provided in, as applicable, the hospital inpatient setting and outpatient department setting.

  • Any code used by for purposes of accounting or billing for the item or service, including, but not limited to, the Current Procedural Terminology (CPT) code, the Healthcare Common Procedure Coding System (HCPCS) code, the Diagnosis Related Group (DRG), the National Drug Code (NDC), or other common payer identifier.

Learn more about how CLAIMEYE can improve your payments adjudications and reimbursements.

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