Claims Resolution

ClinAssist Program Overview

Claims payment has become more complex, particularly for large dollar claims. With the dramatic rise in auto-adjudication and billing errors, payers frequently miss major opportunities for significant savings that can greatly impact their bottom line.

ClinAssist is the leader in complex claims resolution offering payers a complete solution, from initial screening through settlement. ClinAssist employs a state-of-the-art process, hands-on clinical and financial experts and proprietary algorithms to achieve exceptional results.

Conventional medical record audits typically focus on matching services billed to physician orders, resulting in average savings of 2% - 5%. In contrast, ClinAssist's average savings is 20%.*

 

 

 

Program Benefits

  • Significant average savings of
    20%*
  • Complete cycle of claims resolution services including final negotiation
  • Communication with all parties involved in the claims process
  • Constructive negotiation and settlement methods using a panel of experts
  • Increased satisfaction – health plan, employer, member
  • Higher than industry average ROI
  • Preservation of member benefits