Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
A data-driven solution for managing claims and remittances specifically designed for healthcare providers looking to streamline their workflows, enhance resource efficiency, minimize denial rates, and expedite cash flow. Boost your initial claim acceptance rate significantly. Our all-inclusive edits package ensures you remain compliant with evolving payer guidelines and regulations. Increase your team's efficiency with user-friendly, exception-based workflows and automated procedures. Your personnel can conveniently utilize our adaptable, cloud-based platform from any device. Effectively manage your secondary claims volume through the automated creation of secondary claims and explanations of benefits (EOB) derived from the primary remittance advice. Leverage predictive artificial intelligence to identify and prioritize claims that require attention, allowing for quicker error resolution and minimizing denials before submission. Achieve a more efficient claims processing experience. Additionally, print and distribute primary paper claims, or compile and send collated claims along with EOBs for secondary submissions. This holistic approach not only enhances operational efficiency but also promotes better financial performance for healthcare providers.
Description
CORE unites various sectors of the industry to speed up automation and enhance business processes that simplify healthcare for patients, providers, and health plans alike. By leveraging the most reliable source of provider and member information, CAQH empowers healthcare organizations to cut expenses, enhance payment accuracy, and revolutionize their business operations. In the rapidly changing healthcare environment, ongoing advancements in payment and claims processing are crucial. Healthcare providers and health plans nationwide rely on CAQH to gather and oversee professional data, verify primary sources, and keep track of sanctions. Consequently, this leads to more efficient administration, improved regulatory compliance, and superior management of provider information. Ultimately, the collaboration fosters innovation and ensures that all stakeholders benefit from a more effective healthcare system.
API Access
Has API
No
API Access
Has API
No
Integrations
Adobe Document Cloud
Yes
Amazon Web Services (AWS)
Yes
Experian Aperture Data Studio
Yes
Hyperledger Fabric
Yes
Microsoft 365
Yes
Salesforce Data 360
No
Integrations
Adobe Document Cloud
No
Amazon Web Services (AWS)
No
Experian Aperture Data Studio
No
Hyperledger Fabric
No
Microsoft 365
No
Salesforce Data 360
Yes
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
Yes
Online Support
Yes
Customer Support
Business Hours
No
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
No
In Person
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
Yes
Vendor Details
Company Name
Change Healthcare
Founded
2007
Country
United States
Website
www.changehealthcare.com/solutions/revenue-cycle-management/reimbursement-management/assurance-reimbursement-management
Vendor Details
Company Name
CAQH
Founded
2000
Country
United States
Website
www.caqh.org
Product Features
Claims Processing
Adjustor Management
No
Case Management
No
Claim Resolution Tracking
No
Co-Pay & Deductible Tracking
No
Compliance Management
No
Customer Management
No
Electronic Claims
No
Forms Management
No
Paper-Based Claims
No
Payor Management
No
Policy Administration
No
Product Features
Credentialing
Appointment Management
No
Certification Tracking
No
Committee Management
No
Document Management
No
Expiration Management
No
License Verification
No
Online Applications
No
Privileging
No