Claim Audits Simplified

Large Claim Review Process - Simplified.


ClaimLogiq was established to meet the need for a better, more efficient way to review and audit large medical bills.  our Mission is to help payers improve their internal claim review processes and reduce or eliminate their reliance on outside vendors.  



Large claim reviews are critical to controlling costs and maintaining payment integrity.  But lack of transparency makes reviews difficult if not impossible without the right tools.    


The large claim review process is resource-intensive, manual, subjective, and time-consuming – taking several hours or even days to complete.  Our platform reduces that time to minutes.  


Any payer's largest segment of healthcare payments are facility claims. ClaimLogiq’s technology platform provides a means to finally gain control of your internal review department. 


The need for a better solution is clear.  Take control.



Application Highlights


Improved productivity

Having all the tools needed to conduct large claim reviews in one application increases production and is essential to meeting production goals. 

  • System access anywhere providing the ability for team member to work in different locations or telecommute
  • Instant team collaboration whether colleagues are in the next room or in the next state
  • Centralized audit documentation means reviewers are up to speed on a claim review - no matter when it was last touched 

Better Audit Tools & RESOURCES 

In order to meet productivity goals, auditors need the ability to work more efficiently - they need to have better audit tools and resources in a single platform. 

  • Users are presented with tools that speed up the review process 
  • The application has in-line tools and resources which eliminate the need to access multiple systems 
  • Payers have the ability to turn on automated reviews 
  • System includes large claim editing tools including UB04 edits, itemized bill edits, DRG, OCE editing, and more 

Workflow Management

Workflow management is an imperative component to a claim review department.  But without the proper systems, it is impossible to do this effectively.  

  • Audit-specific forms (DRG, MD prep forms, Provider correspondence forms, custom forms, etc.)
  • Management tools that provide departmental results in real-time
  • Audit-specific workflows that help improve review consistency among audit staff