ClaimsXM Managed Service
ClaimsXM is a next generation, scalable managed service solution that integrates claims administration and customer service to enable payer organizations to meet their business needs by assuring timely and accurate payment of healthcare claims. ClaimsXM is a fully integrated claims processing and workflow system utilizing the Facets Core Administration platform which is trusted by more than 75 healthcare organizations. Through our industry experts, standardized processes, cutting-edge technology and data insights our solution will ensure our client's needs are met for today and tomorrow.
OUR CLAIMSXM SOLUTION
Health Plan Administration
Member, Contract, and Provider Management
Coordination of Benefits | eOHI Discovery
Paper to Electronic
Document and Workflow Management
Data Analytics and Reporting
Referral and Authorization
Electronic Claims Management
Auto and Manual Claims Adjudication and Processing
"I'm proud for bringing forth a program that has had the greatest positive impact to Veterans and Providers that I have seen throughout my entire career.
Contracting Officer | Veterans Administration
Transforming the Healthcare Experience
Our ClaimsXM managed service offering represents the culmination of our people, process, and technology.
This data-driven approach to claims administration is an innovative, rules-based solution that streamlines and reduces excess administrative costs, burdens, and inefficiencies.
Since the initial launch in 2021, ClaimsXM has reached an auto-adjudication
rate of over 94% and has processed over 25 million medical claims.