At ClaimLogiq, we go beyond simply providing access to a portal that shows claim review results and letters sent to providers we focus on quality and flexibility.
The “black box” model for claim reviews is no longer acceptable. We define "black box" as sending claims out for audit and waiting on the results to be delivered after a period of time without control or insight into the process. We've been disrupting that model for years with our payer-facing claim analyzing platform that provides real-time transparency into the status of each and every claim, regardless of what stage it is in in the review process.
Depending upon permissions, users can review correspondence between analysts and medical directors, view itemized bills, facility claims data and provider communications, review clinical rationale, run real-time and historical reports, and track the routing of every claim, all within a single platform.
All parties realize that high-dollar inpatient claims are extremely complicated and that itemized bills have thousands of lines of services and charges. Despite this complication, it's our role to make the claims logical and when we present our findings to a provider, and they know ClaimLogiq is involved, they also understand that the findings are real, have been analyzed by experts, and that we are not wasting their precious time substantiating claims or having to perform quality checks against our product. We want to be seen as a partner to both payer and provider to make sure claims are billed and paid correctly and one of the most important ways to create a solid relationship between the payer and provider is to ensure that the product we deliver is outstanding.
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