State Funds

Automated Claims Processing

The Claims Processing Challenge
Today's claims organizations are challenged with three distinct and sometimes competing objectives:

  1. To reduce processing time and cost.
  2. To improve outcomes: pay what is appropriate to pay, don't pay what is inappropriate to pay.
  3. To maximize the use of managed care strategies to control medical costs and improve treatment outcomes.

And while today's document management solutions offer an important first-step in reducing administrative costs, they will not help you meet your competing claims and managed care objectives.

The MedRisk Solution: CLAIMExpert®

CLAIMExpert® goes beyond traditional document management services to provide a comprehensive ASP-based technology solution that meets both your long-term claims and managed care objectives.

CLAIMExpert'®in-depth data acquisition technology fuels the sophisticated and customizable business-rule engine to provide your organization with:

  1. True, end-to-end auto-adjudication capabilities.
  2. 100% consistent, accurate claims handling.
  3. Increased flexibility to easily meet customer needs.
  4. Sophisticated Web-based adjuster tools.
  5. Enterprise level reporting.

Through the use of CLAIMExpert®, our clients have significantly reduced claims processing time and costs. Best of all, CLAIMExpert® helps to improve claims outcomes, facilitate custom workflows for your clients, and simplify the integration of multiple specialty managed care solutions, positioning you to create a strategic advantage for today and tomorrow.

For more information contact us at:

Sales and Marketing
MedRisk, Inc.
2701 Renaissance Blvd., Suite 200
PO Box 61570
King of Prussia, PA 19406
800-225-9675 Toll Free
610-768-5242 Fax