Engagement Models

Flexible Models to Meet The Needs of Your Payment Integrity Program

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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.

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Augment
Reviews

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Promote
Productivity

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Control
Outcomes

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Increase
Transparency

SaaS

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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

Service

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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

Hybrid

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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

Partner Testimonial

“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

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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.

Gain Control Over Your Reviews Today

Schedule a demo with our team to see which model is right for your plan.