Predict360
Predict360, developed by 360factors, serves as a comprehensive risk and compliance management platform designed to streamline workflows and improve reporting for various financial institutions, including banks, credit unions, and insurance companies. This cloud-based SaaS solution consolidates essential components such as regulations, compliance management, risk assessments, controls, key risk indicators (KRIs), audits, policies, and training into one cohesive platform while offering powerful analytics and insights that help clients foresee risks and enhance compliance efforts.
If your current Governance, Risk, and Compliance (GRC) system isn't equipped with an effective analytics and business intelligence tool for creating insightful reports for executives and board members, consider Lumify360 from 360factors. This predictive analytics platform can seamlessly integrate with any existing GRC, allowing you to maintain your workflow processes while equipping stakeholders with the timely reports and dashboards they require for informed decision-making. With these advanced tools at your disposal, you'll be better positioned to navigate the complexities of regulatory compliance and risk management.
Learn more
Service Center
Office Ally's Service Center is relied upon by over 80,000 healthcare practitioners and service organizations to effectively manage their revenue cycles. The platform offers functionality for verifying patient eligibility and benefits, as well as the ability to submit, amend, and monitor claims statuses online while also facilitating the reception of remittance advice. By supporting standard ANSI formats, data entry, and pipe-delimited formats, Service Center significantly enhances administrative efficiency and optimizes workflows for healthcare providers. Furthermore, this comprehensive tool empowers organizations to focus more on patient care by reducing the time spent on administrative duties.
Learn more
CLAIMSplus
Accelerated claims processing is facilitated by various interfaces that effectively align with your corporate branding. Our digital ecosystem provides access from any location at any time, promoting both convenience and flexibility. The handling of Health and Life claims is optimized through sophisticated systems tailored to meet your unique processing needs. We improve the claims lifecycle to match the influx of incoming claims while also managing and resolving more intricate claims at remarkable speeds. The entire process remains swift and continuous, successfully eliminating any delays associated with claims processing. CLAIMSplus enhances the claims journey by partnering with employers, third-party administrators, and insurers, leveraging robust cloud-based processing technologies. At CLAIMSplus, our goal is to refine operational processes and expedite medical claims through secure, reliable, and efficient electronic claims management solutions. Our innovative technology is ultimately built to address claims in a timely and effective manner. Additionally, feedback from our clients consistently emphasizes that the rapidity of the claims process is paramount in successful claims management, reinforcing our dedication to maintaining high efficiency in all aspects of our service. This commitment not only benefits our clients but also contributes to a better overall experience for claimants.
Learn more
Virtual Examiner
The Virtual Examiner®, developed by PCG Software, serves as a comprehensive tool for overseeing an organization’s internal claims process, efficiently tracking provider data to identify fraudulent or abusive billing practices while enhancing financial recovery. This advanced software enables healthcare organizations to optimize their claims adjudication systems, processing over 31 million edits per claim, which significantly streamlines operations. By meticulously monitoring the internal claims processes, it effectively pinpoints and mitigates payments made for incorrect or erroneous codes, ultimately preserving premium dollars. Beyond mere claims management, the Virtual Examiner® acts as a robust cost containment solution that analyzes claims for not only abusive billing patterns but also those that may require attention to third-party liability coordination, case management opportunities, physician billing education, and various other valuable cost recovery insights. Its multifaceted approach provides healthcare organizations with the tools they need to navigate complex billing landscapes and improve overall financial health.
Learn more
