Our solutions help Self-Insured and Self-Administered organizations overcome obstacles and achieve their goals.

Browse our Solutions for Self-Insured/Self-Administered Organizations

Click for more information on each product

CLAIMExpert

Looking to maximize efficiency and reduce manual processes? Using a powerful rules engine our expert claims processing platform streamlines workflow.Click to Learn More »

ODG Scoring

ODG’s evidence-based guidelines are embedded into our systems, giving you a 360° view of your claims in one place for the most accurate claims monitoring.Click to Learn More »

DataPlus Service

Smooth document intake- information is keyed, tagged, digitized and validated at the onset. This allows for easy searching later in the claims process.Click to Learn More »

Referral Tool

Our system automatically pre-populates and sends referral requests to negotiated partners- saving time, reducing errors and maximizing network penetration.Click to Learn More »

Relatedness/Rarity Screening and UR Enforcement

Our system scans incoming bills for relatedness, rarity or medical necessity, flagging adjusters when it finds an inconsistency.Click to Learn More »

Bill Review and Re-Pricing

Our bill review service ensures that all bills are valid and reduces charges to proper fee schedule or UCR, providing vast savings on bill review.Click to Learn More »

Reporting and Analytics

Gain valuable insight from your claims data with our comprehensive dashboard reporting services. Real-time updates and drill down capabilities let you focus your resources where they are most needed.Click to Learn More »

PACKETExpert

The industry’s premier automatic packet creation tool assembles packets while identifying and eliminating duplicates within. Before final delivery packets undergo manual review and validation.Click to Learn More »