Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
ClaimScore stands out as the sole independent software solution focused on tackling the growing issue of claim fraud within class action settlements. Each claim is meticulously assessed on an individual basis through our unique AI, ML, and Cloud Architecture in real-time, with results displayed instantly on an interactive dashboard. Initially, every claim starts with a ClaimScore of 1,000, which diminishes whenever it does not meet a specific criterion. These criteria are assigned either fixed or variable weights based on their relationship to fraudulent and legitimate claims. To enhance transparency, every claim is accompanied by deduction codes that correspond to the failed criteria, ensuring that all involved parties, including the administrator and the court, are fully informed of the precise reasons behind any claim rejection. This meticulous approach not only fosters trust among stakeholders but also reinforces the integrity of the claims process.
Description
Utilizing our claims listing page enables you to swiftly address any errors or omissions before you submit your claims. Once all necessary information has been recorded and the relevant diagnosis and modifier codes have been applied, you can effortlessly upload a batch of claims to Trizetto Provider Solutions® in a single action. Following this, Trizetto Provider Solutions® conducts an additional round of claim scrubbing before forwarding your submissions to the appropriate payers. After payments from insurance companies are processed, you will see updates against claims that reflect allowed amounts, adjustments, copays, coinsurance, and deductibles. To maintain precision, payments are entered in groups. Statements are prepared according to your specified frequency—be it daily, weekly, or monthly—and are designed in a straightforward format that patients can easily comprehend. This clarity eliminates any prior confusion! Furthermore, a section for credit card authorization is included on the statement to facilitate the convenient settlement of any outstanding balances, ensuring a smooth payment process for patients.
API Access
Has API
No
API Access
Has API
No
Integrations
No details available.
Integrations
No details available.
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)
No
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
No
In Person
No
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
No
In Person
No
Vendor Details
Company Name
ClaimScore
Founded
2022
Country
United States
Website
www.claimscore.ai
Vendor Details
Company Name
Mack Software
Website
www.macksoftware.com/mdoc.html
Product Features
Insurance Claims Management
CRM
No
Claims tracking
No
Customer portal
No
Document management
No
EDI data exchange integrations
No
Electronic claims
No
Fraud management
No
Reporting
No
Product Features
Billing and Invoicing
Billing Portal
Yes
Contact Database
Yes
Contingency Billing
No
Customer Portal
No
Customizable Invoices
No
Dunning Management
Yes
Hourly Billing
No
Invoice History
No
Mobile Payments
No
Multi-Currency
No
Online Invoicing
No
Online Payments
No
Payment Processing
Yes
Project Billing
No
Recurring/Subscription Billing
No
Service Ticket Billing
No
Tax Calculator
Yes