Payers and TPAs
+ REVELOHEALTH.
Provide a robust repricing application that not only stores details related to sophisticated payer contracts but also supports a customized solution for your plan administration.
Customizable solutions to mitigate claim errors by developing routing rules for ease of identification to prevent member and provider abrasion. Data is old from day one. Do you ever find yourself asking, is that claim really non-par?
We are the conduit for all things claims. From consuming claims from multiple sources to routing claims... there is no limitation.
How it
works.
Benefits.
Analytics: full claims reconciliation process to ensure what comes in...comes out.
Data Matters: Claims re-pricing details at all levels including network, provider, group, member, narrow code set, claim type, place of service.
Speed: 98% of claims or greater received are repriced automatically and returned via repriced 837 standard claim file to you within 24 hours from receipt.
Reconciliation: Our iSTACK™ analytics system gives payers the ability to reconcile the number of claim files sent to our system and the number of claims within your files received.
Audit: Our iSTACK™ analytics system also gives you 100% audit control over all your claims for pricing accuracy with user defined special routing or pricing rules to serve your client’s needs.
Value: REVELOHEALTH is setting a new operational standard in payer claims and ERISA plan services