Ratings and Reviews 0 Ratings

Total
ease
features
design
support

This software has no reviews. Be the first to write a review.

Write a Review

Ratings and Reviews 0 Ratings

Total
ease
features
design
support

This software has no reviews. Be the first to write a review.

Write a Review

Alternatives to Consider

  • Cloud Claims Reviews & Ratings
    11 Ratings
    Company Website
  • Service Center Reviews & Ratings
    72 Ratings
    Company Website
  • XpertCoding Reviews & Ratings
    34 Ratings
    Company Website
  • tigerlab Reviews & Ratings
    11 Ratings
    Company Website
  • Elation Health Reviews & Ratings
    72 Ratings
    Company Website
  • Guardz Reviews & Ratings
    56 Ratings
    Company Website
  • Macaw AMS Reviews & Ratings
    5 Ratings
    Company Website
  • Quaeris Reviews & Ratings
    6 Ratings
    Company Website
  • Predict360 Reviews & Ratings
    18 Ratings
    Company Website
  • Fraud.net Reviews & Ratings
    56 Ratings
    Company Website

What is Context 4 Health Plans Suite?

Ensure the dependability of your health plan while identifying precise pricing through the Context4 Health Plans Suite, our adaptable and cloud-based technological solution. Gain immediate and actionable insights for identifying Fraud, Waste, and Abuse (FWA), crafted by our team of certified experts proficient in clinical, dental, and health benefits. By utilizing reliable data along with cutting-edge cloud technology, we provide a strong and justifiable Medicare reference-based pricing (RBP) solution. Our platform integrates over 100 healthcare data sets, further enhanced by expert guidance to improve operational efficiency and maintain regulatory compliance. Moreover, our advanced medical coding software is designed to facilitate claim submissions and minimize the chances of denials. In addition, our cloud-based Payment Integrity Platform employs a distinctive analytics engine to detect coding errors, evaluate medical necessity, tackle unbundling, and identify fraud, waste, and abuse, while also assessing audit risks and uncovering pricing inconsistencies that could greatly impact your organization’s overall performance. This all-encompassing strategy not only protects your financial stability but also equips you for lasting success in the dynamic healthcare environment. With our commitment to innovation, you can navigate challenges with confidence and ensure a future of continued growth.

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.

Media

Media

Integrations Supported

Virtual Benefits Administrator (VBA)

Integrations Supported

Virtual Benefits Administrator (VBA)

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
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

Context4 Healthcare

Date Founded

1988

Company Location

United States

Company Website

www.context4healthcare.com

Company Facts

Organization Name

Complete Health Systems

Company Website

completehealthsys.com/claims/

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 Claims Management

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

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

Popular Alternatives

Popular Alternatives

Enter Reviews & Ratings

Enter

Enter, Inc
HealthRules Payer Reviews & Ratings

HealthRules Payer

HealthEdge Software
MediClaims Reviews & Ratings

MediClaims

WLT Software
Complete Claims Reviews & Ratings

Complete Claims

Complete Health Systems