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Average Ratings 0 Ratings

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ease
features
design
support

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Write a Review

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

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.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

Adobe Document Cloud Yes 
Amazon Web Services (AWS) Yes 
Experian Aperture Data Studio Yes 
Hyperledger Fabric Yes 
Microsoft 365 Yes 

Integrations

Adobe Document Cloud No 
Amazon Web Services (AWS) No 
Experian Aperture Data Studio No 
Hyperledger Fabric No 
Microsoft 365 No 

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 Yes 
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 No 
Webinars No 
Live Training (Online) No 
In Person No 

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

ClaimScore

Founded

2022

Country

United States

Website

www.claimscore.ai

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

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 

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