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What is Complete Claims?

Claims adjudication services encompass a variety of sectors such as medical, dental, vision, and prescription claims, along with both short and long-term disability cases. These services can be accessed on-site with a license or through a hosted application model (ASP). Powered by Microsoft technology, the system employs an SQLServer database and a Windows front end for optimal performance. Our customer service team is highly esteemed, comprised of healthcare claims experts with at least 12 years of experience in the industry. Every support request is documented, allowing clients to track their status online. The system includes a plan copy and modification feature that enables quick implementation of changes. Auto-adjudication is facilitated through benefit codes built on business rules that take into account over 25 variables related to both claims and claimants, all processed by the adjudication engine. Submissions can be made in various formats, including scanned images, EDI, or traditional paper submissions. The system adheres to HIPAA EDI 5010 transaction sets, guaranteeing secure and efficient processing. Furthermore, re-pricing fees and UCR schedules can be entered into the system ahead of their effective dates, while the date-driven logic ensures re-pricing is executed based on the service date, enhancing the overall workflow of claims processing. This comprehensive solution not only streamlines claims management but also significantly improves client satisfaction and operational efficiency.

What is ALFRED Claims Automation?

Filing claims is often a complex yet vital task that many people, more than 60%, choose to avoid due to its convoluted nature and the significant time it demands. Artivatic has developed a tailored claims platform that addresses the needs of various insurance sectors, allowing companies to provide a seamless digital claims experience, facilitate self-processing, automate assessments, and improve the detection of risks and fraud while also managing claims payments. This innovative platform is designed to meet all your claims-related needs, delivering a fully automated and thorough evaluation process. Whether you're dealing with auto, health, travel, accidental, death, fire, SME, business, or commercial claims, this solution ensures comprehensive coverage. By simplifying the claims mechanism, Artivatic seeks to boost operational efficiency and enhance overall customer satisfaction, paving the way for a more user-friendly experience in the insurance landscape. With such advancements, the future of claims processing looks significantly brighter.

Media

Media

Integrations Supported

Amazon Web Services (AWS)
Apache Cassandra
Google Cloud Platform
IBM Cloud
Microsoft 365
Microsoft Azure
Microsoft Dynamics 365
Oracle Cloud Infrastructure
Oracle Database
PostgreSQL

Integrations Supported

Amazon Web Services (AWS)
Apache Cassandra
Google Cloud Platform
IBM Cloud
Microsoft 365
Microsoft Azure
Microsoft Dynamics 365
Oracle Cloud Infrastructure
Oracle Database
PostgreSQL

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

$10/claims/month
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Complete Health Systems

Company Website

completehealthsys.com/claims/

Company Facts

Organization Name

Artivatic.ai

Date Founded

2017

Company Location

India

Company Website

alfred.artivatic.ai/

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Insurance Agency

Claims Management
Commission Management
Contact Management
Document Management
Insurance Rating
Life & Health
Policy Management
Property & Casualty
Quote Management

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

Insurance Policy

Cancellation Tracking
Claims Tracking
Policy Generation
Policy Issuance
Policy Processing
Quotes / Estimates
Rating Engine
Reinstatement Tracking
Reinsurance Administration
Renewal Management
Underwriting Management

P&C Insurance

Billing & Invoicing
Broker / Agent Portal
Claims Management
Commission Management
Customer Portal
Document Management
Insurance Rating
Marketing Automation
Policy Management
Quote Management
Reinsurance Administration
Underwriting Management

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