Solutions

CLAIMwerks™ - Enhanced Claims Management

Real-time claims screening and analysis for coding compliance, validation and pre-adjudication features: Clean up claims with actual contract rules and fee schedules before submission.

• Available single point eligibility and deductibility verification
• Contract rules and fee schedule management, with price validation against payer-specific agreements
• Automated claims status tracking, auditing and reconciliation features
• Daily and other meaningful periodic reports and financial information, to determine and track expected claims values. See sample reports here.

BILLwerks™ Billing Services

Augments CLAIMwerks™ with complete back office billing and collection service functions. We do the follow-up collections from the insurance companies for you.

FUNDwerks™ - Immediate Funding for Medical Receivables

As claims are processed, an appraised amount expected to be paid is calculated. We lend on a percentage of the expected amount:

• Secured by medical claim receivables, not relying on personal credit guarantees
• Allowing providers to receive funds electronically within one banking cycle: 1-3 business days of claim submission

Each claim has a ‘micro-loan’ offered at attractive rates. When the claim is paid the loan is automatically paid off by the system.