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.
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Cloud Claims
APP Tech has been at the forefront of implementing an incident-based methodology in claims and risk management since its inception in 2003, providing advanced technological solutions to a wide array of clients throughout North America. Our integrated systems have enhanced efficiency and scalability in claims management, improved visibility, accelerated response times, reduced premium costs, and mitigated risk events for numerous customers.
Cloud Claims by APP Tech stands out as an acclaimed software solution for risk management and claims processing. Designed specifically for self-insured organizations, third-party administrators, and businesses aiming to monitor their claims and losses, IMS facilitates comprehensive management of the claim lifecycle—from the initial incident report to payment processing and collections. The platform boasts a rich assortment of features that empower users with full oversight of both their claims and associated risk data, including incident and claims management, collaborative tools, detailed reporting, and insurance tracking, among many others.
We take great pride in our flawless implementation success and outstanding customer retention rates, which stem from our dedication to thoroughly understanding our clients’ unique demands and delivering tailored solutions that effectively address those needs. Furthermore, our ongoing support ensures that clients maximize the benefits of our software long after implementation.
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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.
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EvolutionIQ
Our cutting-edge solutions contribute to decreased loss costs, lower expenses, and heightened customer satisfaction, proving their value through collaborations with leading carriers. EvolutionIQ is pioneering the transformation of the claims management process for complex coverage lines, promoting a strong partnership between skilled professional adjusters and a specially crafted predictive guidance system. By offering clear prioritization, timely claim alerts, and extensive context, empowered adjusters can effectively reduce losses and costs while improving the claimant experience. This method also reduces unnecessary fluctuations in the claims process by utilizing a consistent and scalable guidance framework. Moreover, it enhances the allocation of adjuster resources, resulting in fewer redundant claim evaluations and enabling focused investigations that help prevent litigation and guarantee prompt settlements. Our claims AI systematically collects and employs data to provide the strategic insights essential for your team’s achievements. In addition, EvolutionIQ merges both structured and unstructured data from carriers with our proprietary third-party data, boosting overall operational efficiency and effectiveness. This collaboration not only simplifies workflows but also positions your organization for enhanced success in the claims domain, ultimately leading to a more reliable and efficient claims resolution experience. As we continue to innovate, our solutions adapt to the evolving needs of the industry, ensuring that your organization remains competitive and responsive.
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