Claims Editing

Complete clinical editing using our totally customizable software and transparent framework to provide lightning-fast results with razor sharp accuracy.

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Customized Claims Editing

ClaimLogiq software clinical editing can be applied pre-pay and post-pay to both Professional and Institutional claims using our solution as full SaaS or, services model customize to fit the needs of every Payer.

Icons_1_Web Optimization-1Customize Rules 

Maximize auditing capabilities for Commerical, Medicaid, and Medicare claims with a customized platform updated in real-time.

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ClaimLogiq software provides a solution with measurable value in reducing appeals, improving cost savings, and predictable, defensible outcomes.

Icons_1_Campaign TimingFast, Accurate Results

Don't just un-bundle and edit, adapt our agile software to the specific needs of each Payer in real-time for maximum professional claims payout.

Controlled Clinical Editing

ClaimLogiq software includes industry-standard edits such as global periods, CCI editing, multiple procedure reductions, assistant-at-surgery reimbursements and incidental services complemented by the capability of editing itemized bills on institutional claims.

CLQ.Clinical Editing . Vertical

Comprehensive & Compliant

Working with ClaimLogiq gives Payers the resources needed to identify payment accuracy errors, quickly overcome savings obstacles and navigate professional claims editing using a secure, payer-facing platform.

Historical & Real-Time Data

Access and easily identify omissions, errors and questionable coding utilizing a robust suite of reports and dashboard insights into clinical editing data and workflows.

Transparent & Customizable

View and customize rules and edits real-time with user-level specific access for a streamlined claims adjudication process.

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Quickly, Accurately and Easily Identify Billing and Coding Accuracy

Compliant Claims Editing

A comprehensive and powerful editing environment that adapts real-time to industry rules and edits with transparency and client-driven control over the entire process.

The Latest Coding Principles

ClaimLogiq software includes the ability to update coding principles in real-time with zero delays and always the most up-to-date edits.

HITRUST Certified

Request and review all medical records for billing reviews and accuracy in a secure, HIPAA compliant, and HITRUST certified environment.

Custom Medical Record Submission

Submit medical records that satisfy efficient workflows through paper, portal, and electronic file feeds, customized to every Payers' needs.

Low-Touch Provider Relations

We take a minimum necessary approach to Medical Records requests and standardize the approach based on prescreen rules so that providers experience consistent, familiar requests.

Line-Level Detail

ClaimLogiq provides built-in offer customer service support tools to provide line-level detailed claims decisions.

Customized Fit

ClaimLogiq software is designed to fit the needs of clinical editing for all commercial, Medicaid, and Medicare claims.

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Reference Based Pricing

Go beyond cost savings and containment with sustainable, scaleable cost management. Employ our intelligent, objective payer-facing framework to adjudicate any size claims at the fastest speed to pay.

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Out of Network Services

The team at ClaimLogiq work alongside providers and payers to enable the careful management of requirements and maintain the lowest abrasion.  Intelligent technology routes the right claim to the right expert, every time.

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  • SaaS

    Access our HITRUST certified platform from any remote location, securely and never miss a beat using your team experts to audit and analyze any size claims.

  • Services

    Our payer-facing platform is used by our team of experts to deliver on payment integrity goals for all size payers delivering maximum ROI and higher cost savings.

  • Combination

    Customize the ClaimLogiq experience with a combination of software and services to address specific requirements and goals of your payment integrity program.

Hospital Bill Audit

ClaimLogiq's automated itemized bill editing includes customizable denial libraries, and feature-rich review functionality that improves the i-bill review speed and accuracy across all team members.

  • Razor-Sharp Accuracy
  • Customized Libraries
  • Expert Auditors and Experienced Professionals
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hospital bill audit
DRG Reviews

DRG Reviews

ClaimLogiq's unique payer-facing technology and proven solution DRG validation strategy yields optimal recoveries with not just maximum cost avoidance but also minimized abrasion and enhanced relationships.

  • Low Appeal Rates
  • Experienced Auditors
  • Controlled Outcomes
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Our unique approach

We help healthcare payers of all sizes overcome the complexities of healthcare claims through a transparent and customizable software solution.

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