ClaimsXM combines industry expertise, streamlined processes, advanced technology, and data insights to maximize efficiency, increase automation, and exceed security standards.
ClaimsXM can handle various functions of a health plan beyond claims processing including billing, auto-enrollment and others to allow for complete customization.
The modularity of ClaimsXMs allows for rapid configuration changes to specific program areas without incurring costly and untimely implementations.
ClaimsXM is a multi-tenant cloud hosted model that ensures client autonomy and security while maintaining cost-effective and scalable solutions.
The Industry's Most Secure Claims Environment
ClaimsXM is FedRAMP® Certified
ClaimsXM by the Numbers
94%+
Claims Auto-Adjudication Rate
2 Day
Clean Claim Rate
96%
of Payments Made In 30 Days
5
Industry Awards
Improve Outcomes with ClaimsXM
Delivering accurate, efficient claims processing is essential to supporting federal healthcare partners. ClaimsXM helps transform the claims experience through streamlined processes, advanced technology, and a team dedicated to getting it right.
Launched in October of 2021, ClaimsXM was designed to replace an antiquated federal claims processing system. The highly configurable, business-rules-oriented platform represents an implemented proof of concept that successfully solved historical challenges in the federal healthcare ecosystem.
With our data-driven approach, ClaimsXM effectively streamlines administrative functions, eliminates administrative backlogs, and addresses manual claims challenges. The Integration of ClaimsXM provides seamless integration with various electronic health record (EHR) platforms. ClaimsXM combines claims administration and customer service to reduce healthcare costs, increase access to care, and address provider frustrations.
Built on the trusted Facets Core Administration platform and hosted in the secure government cloud, ClaimsXM combines industry expertise, streamlined processes, advanced technology, and data insights to meet the needs of each individual user. ClaimsXM meets rigorous security standards and can host any system on a Day 1 FedRAMP® certified platform.
The Industry's Leading Claims Adjudication System
ClaimsXM has a configurable architecture that supports complex eligibility structures, custom claims edits, and dynamic rule sets, making it adaptable to program-specific requirements. The system is designed to streamline claims processing with security, flexibility, and scalability at its core. ClaimsXM is hosted in the Microsoft® Azure Government Cloud and powered by an industry-leading, commercial-off-the-shelf (COTS) adjudication engine.
ClaimsXM is a FedRAMP® certified cloud-based claims adjudication system that fully complies with federal privacy and security regulations, including HIPAA, NIST, and FISMA.
Signature leverages our dedicated ClaimsXM subject matter experts for configuration, ensuring government policy is accurately and efficiently translated into business logic.
ClaimsXM has a configurable architecture that supports complex eligibility structures, custom claims edits, and dynamic rule sets, making it adaptable to program-specific requirements.
ClaimsXM adds advanced automation, low-code/no-code configuration, and rapid change management, enabling faster adaptation to policy and regulatory changes.
