Real-time claims resolution. Re-engineering how we process and pay for healthcare.
A Preferred Provider Organization with about 9,000 providers in three states.


OBJECTIVE
A fragmented and confusing healthcare payment and processing system, which ultimately hurts everyone, the patient, the provider and the payor.


METHODS
Create a real-time claims resolution system which links everyone for quick payment of the claim at the point of service.


RESULTS
Reduces paper and accelerates the claims cycle.


CONCLUSIONS
"Re-engineer the current system of processing and paying healthcare claims with a business model that economically benefits all parties."
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Council for Affordable Health Insurance, Alexandria, VA, USA.
D005069:Evaluation Studies as Topic; D007344:Insurance Claim Reporting; D007345:Insurance Claim Review; D008331:Management Information Systems; D009862:Online Systems; D019982:Organizational Case Studies; D011243:Preferred Provider Organizations / Q000191:economics*; D012984:Software; D014481:United States