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What is MediClaims?

WLT's MediClaims platform offers a cost-effective, intuitive, and highly efficient approach to benefit and claims management. The incorporation of a rules-based structure, along with seamless EDI capabilities, guarantees that claims are processed quickly, easily, and accurately. This system accommodates a wide variety of benefits and claims, such as Medical, Dental, Vision, Prescription Drugs, Consumer-Driven Healthcare, Disability, and Capitation processing. Users of WLT's MediClaims can effortlessly tailor group configurations to support either straightforward coverage or complex benefit plans with multiple lines of coverage. To enhance operational effectiveness, a powerful information system is vital, and WLT consistently embraces state-of-the-art technologies, providing the most innovative and flexible solutions on the market. In today's rapidly changing healthcare environment, having access to such a versatile claims processing system is essential for sustaining a competitive edge and guaranteeing customer contentment. The adaptability of the system enables organizations to respond to emerging challenges and opportunities with greater agility.

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

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

API Availability

Has API

Pricing Information

$1 one-time payment

Pricing Information

Pricing not provided

Supported Platforms

SaaS

Supported Platforms

SaaS

Customer Service / Support

24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support

Training Options

Documentation Hub

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

WLT Software

Date Founded

1979

Company Location

United States

Company Website

wltsoftware.com/mediclaims/

Company Facts

Organization Name

Cervey

Date Founded

1978

Company Location

United States

Company Website

cervey.com

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

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