
ClaimsXM
ClaimsXM is a scalable, next-generation managed service that integrates claims administration and customer service to ensure timely, accurate healthcare payments. 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.
Industry Expertise
Streamlined Processes
Advanced Technology
Data Insights
ClaimsXM Capabilities
Health Plan Administration
Member, Contract, and Provider Management
Payer Credentialing
Coordination of Benefits | eOHI Discovery
Paper to Electronic
Document and Workflow Management
Data Analytics and Reporting
Referral and Authorization
Electronic Claims Management
Payment Integrity
Auto and Manual Claims Adjudication and Processing
Payment Processes
Payment/Pricing Methodology
The ClaimsXM Difference
Hosted in the secure cloud, ClaimsXM meets rigorous security standards and has the ability to host any system on a Day 1 FedRAMP authorized platform.
With our data-driven approach, ClaimsXM effectively streamlines administrative functions, eliminates administrative backlogs, and addresses manual claims challenges.
The Integration of ClaimsXM and our workflow design provides seamless integration with various electronic health record (EHR) platforms.
Streamline Your Operations with Customizable Configurations
Modular Capabilities
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ClaimsXM is capable of handling various functions of a health plan beyond claims processing including billing, auto-enrollment and others to allow for client customization.
Configuration​
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The Modularity in ClaimsXMs design allows for rapid configuration changes to specific program areas without incurring costly and untimely implementations.
Hosted Model​
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ClaimsXM is a multi-tenant cloud hosted model that ensures client autonomy and security while maintaining cost-effective and scalable solutions.
Improve Your Operation with ClaimsXM
01
Improve Claims Processing Timeliness
03
Reduce Provider Frustrations
02
Improve Accuracy and Transparency
04
Improve Compliance and Security

Transforming Claims Administration
By automating healthcare claims administration, ClaimsXM reduces the time required to handle each claim, allowing Payers to process a higher volume of claims more quickly and with higher accuracy.


95%
of claims are processed automatically.


96%
of payments are made within 30 days.

