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What is Assurance Reimbursement Management?

Explore a specialized analytics-driven tool crafted for healthcare providers to effectively manage claims and remittances, aiming to refine workflows, optimize resource utilization, decrease denial rates, and improve cash flow. Enhance your initial claim acceptance rates with our comprehensive editing suite that ensures compliance with the latest payer guidelines and regulations. Increase your team's productivity by leveraging intuitive workflows that focus on exceptions while automating repetitive tasks. Your staff can easily access our adaptable, cloud-based platform from any device, promoting uninterrupted operations. Simplify the handling of secondary claims with the automatic generation of secondary claims and explanations of benefits (EOB) derived from primary remittance advice. Utilize predictive artificial intelligence to prioritize claims that need urgent attention, facilitating quicker error resolution and reducing the likelihood of denials before submission. Whether you are processing primary paper claims or organizing claims and EOBs for secondary submissions, you will experience enhanced efficiency in your claims processing. By adopting these innovative features, you can substantially improve your claims management approach and take your practice to the next level. This progressive solution not only streamlines operations but also empowers your team to focus on delivering exceptional patient care.

What is Adjudicator?

Adjudicator functions as an innovative platform designed for the administration of plans and the evaluation of prescription claims, catering to a diverse range of entities, including pharmacy benefit managers, hospitals, health systems, managed care organizations, and retail pharmacies. This platform boasts customizable plan configurations and benefit structures, supports multi-tenant environments, and facilitates the oversight of pharmaceutical networks, drug formularies, and maximum allowable cost (MAC) pricing. Users gain access to a member portal that provides real-time information on benefit statuses and the ability to track pending claims, along with options for secure document uploads and timely alerts. Moreover, a prior authorization dashboard offers insights into claims data while fostering secure communication among various stakeholders. An integrated API framework allows for efficient data exchange with both internal systems and external partners, ensuring smooth interoperability. By equipping organizations with these robust tools, Adjudicator enables effective management of pharmacy benefits and prescription claims, significantly improving operational efficiency and the quality of service provided to members. Ultimately, the comprehensive features of Adjudicator allow stakeholders to remain agile in response to the dynamic landscape of healthcare and pharmacy management, ensuring they are well-prepared for future challenges.

Media

Media

Integrations Supported

Adobe Document Cloud
Amazon Web Services (AWS)
Experian Aperture Data Studio
Hyperledger Fabric
Microsoft 365

Integrations Supported

API Availability

API Availability

Has API

Pricing Information

Pricing not provided

Pricing Information

Pricing not provided

Supported Platforms

SaaS

Supported Platforms

SaaS

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support

Training Options

Documentation Hub
Webinars
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Change Healthcare

Date Founded

2007

Company Location

United States

Company Website

www.changehealthcare.com/solutions/revenue-cycle-management/reimbursement-management/assurance-reimbursement-management

Company Facts

Organization Name

Cervey

Date Founded

1978

Company Location

United States

Company Website

cervey.com

Categories and Features

Categories and Features

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