Flexible Models to Meet The Needs of Your Payment Integrity Program
Designed Specifically for Your Team
We’ve designed our models to be flexible to your needs. Whether you implement our SaaS solutions into your existing workflow, leverage ClaimLogiq experts, or a combination of both, you’ll drive cost savings and optimize resources.
Our platform is a unique cloud-based HITRUST certified solution, designed to control outcomes and increase efficiencies throughout your Payment Integrity program.
Completely transparent business rules, edits and denials that are configurable by plan and provider
Algorithms that learn provider-specific denials which are leveraged in future claims
Cross-claim validation ensuring agreement between professional and institutional claims
No matter the complexity or volume of claims, our experts uncover tangible cost savings.
Ability to flex claim volume without Increasing internal staff
Seamlessly send encountered cases to ClaimLogiq as needed
Pre-established business rules engine and protocols drive reviews; the platform keeps clients and ClaimLogiq staff aligned
A combination of services and enabling technology that drives cost savings, tailored to each payer and program need.
Payers can use the platform internally or, when needed, route cases seamlessly to ClaimLogiq’s staff for external review
We provide complete transparency into the life cycle and progress of every claim during every step of the process
“We went with ClaimLogiq because of their transparency and ability to go from service to hybrid…they will help take us places we’re not at today.”
- Payment Integrity Executive with Large Insurance Carrier
Shifting from Outsourced to In-House Payment Integrity
As a partner that provides a platform to enable internal health plan resources to manage their reviews, or utilize a service model to augment reviews, no matter where you are on your payment integrity journey, ClaimLogiq’s collaborative partnership will meet and support you every step of the way.
ClaimLogiq supports your payment integrity journey through flexible engagement models and a data-driven approach.
Click the video, to learn more about our payment integrity solution.