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Average Ratings 0 Ratings

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ease
features
design
support

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Description

Safeguard the reliability of your health plan while pinpointing precise pricing with the Context4 Health Plans Suite, our versatile and cloud-centric technological framework. Experience immediate and actionable insights for detecting Fraud, Waste, and Abuse (FWA), developed by our skilled team of certified experts in clinical, dental, and health benefits. By leveraging accurate data and state-of-the-art cloud technology, we deliver a robust and defensible Medicare reference-based pricing (RBP) solution. Our platform comprises over 100 healthcare data sets, complemented by professional guidance to enhance operational efficiency and ensure regulatory compliance. Additionally, our sophisticated medical coding software is tailored to streamline claim submissions and reduce the likelihood of denials. Furthermore, the cloud-based Payment Integrity Platform harnesses our unique analytics engine to uncover coding mistakes, assess medical necessity, address unbundling, detect fraud, waste, and abuse, evaluate audit risks, and identify pricing discrepancies, all of which can significantly influence your organization's performance. This comprehensive approach not only safeguards your financial health but also positions you for sustainable success in the ever-evolving healthcare landscape.

Description

Remittance advice often encompasses a vast number of intricate transactions, compelling healthcare providers to engage in expensive and time-consuming manual data entry to fulfill essential patient accounting functions. To streamline this process and enhance billing efficiency, many healthcare organizations have adopted cutting-edge computer-aided recognition technologies that can extract transaction-related data from paper documents. Although this technology has demonstrated its capability to accurately pull essential data elements, several processing tasks unique to Explanation of Benefits (EOBs) still need to be tackled to ensure effective implementation. The Optiform eobXL™ for Kofax Capture solution offers a comprehensive suite of features designed to meet these specific requirements, along with data and image integration needs, all presented within an easy-to-use, “point & click” interface. By leveraging this solution, healthcare providers can further reduce the burden of manual data entry and improve overall operational efficiency.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

Virtual Benefits Administrator (VBA)

Integrations

Virtual Benefits Administrator (VBA)

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

Context4 Healthcare

Founded

1988

Country

United States

Website

www.context4healthcare.com

Vendor Details

Company Name

Optiform

Founded

1994

Country

United States

Website

www.optiform.com

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

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