Claims Processing

We process more than 243,000 claims a year totaling over $78 million in benefit payments for 15,000 employees. We are paperless and leverage our technology to maximize our auto-adjudication rates. 60% of claims are never touched by a human, resulting in faster turnaround times and accurate payments. Our financial and procedural accuracy is consistently 99% and above.

All our claim processors provide direct customer service, answering questions from employees and providers in addition to processing claims. Our team is assigned and trained in the specifics of the client’s plan design as well as briefed on how to best interact with their corporate culture. This integrated approach to processing and customer service adds experience and background knowledge to the process that is not available in a “call center” environment.

Our claims system offers flexibility in plan design and has comprehensive built-in edits, providing the highest level of customization, auto-adjudication and protection against financial loss.