Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
I-CAPS stands for Intelligent Claims Administration System, designed to comprehensively cover all aspects of the health claims payment sector through a unified architecture that meets the diverse requirements of payers, including areas such as membership management, billing, enrollment, mailroom operations, claims processing, network oversight, contracting, pricing strategies, utilization reviews, and customer support. Our I-CAPS, along with our Advanced Value Scale (AVS) coding compliance software, facilitates informed decision-making to assist clients in managing expenses effectively. The Advanced Network Administrator (ANA) ensures the accuracy of provider information in an efficient manner, while our Resource-Based, Usual Customary, and RESPONSIBLE fee schedule (RB-UCR) is a pioneering solution in the market, built on RBRVS and NCCI frameworks. For a thorough assessment of your plan or provider’s performance, consider utilizing our Cost Containment Audit and Recovery Services (CCARS), which provide a meticulous and non-intrusive evaluation of claims efficiency. This holistic approach not only enhances operational effectiveness but also promotes greater transparency within the health claims ecosystem.
Description
Riskonnect Claims Management Software is an advanced claims administration platform that helps organizations efficiently manage claims from the initial incident report to final closure. The system centralizes claims information, automates workflows, and connects data from multiple internal and external sources to improve visibility and streamline operations. Businesses can use the platform to simplify claims intake with mobile-friendly forms, automatic alerts, instant data validation, and real-time access to critical information. The software includes robust capabilities for assignment management, reserve tracking, adjudication workflows, settlement processing, subrogation management, and return-to-work coordination. Integrated AI and predictive analytics tools help claims teams identify litigation risks, detect potential problem claims early, estimate claim durations, and make faster, more informed decisions. Riskonnect also supports compliance management through electronic filing tools for workers’ compensation reporting and proactive monitoring of regulatory requirements. Collaboration features enable adjusters, claimants, insurers, and third-party partners to communicate and share information more effectively throughout the claims process. The platform integrates with more than 900 external systems used by carriers and third-party administrators, allowing organizations to unify and validate claims data across different environments. Custom dashboards, reporting tools, and analytics capabilities provide actionable insights that help businesses evaluate performance, reduce costs, and optimize resource allocation. Automated task management and configurable workflows reduce administrative burdens while helping organizations accelerate claim resolution times.
API Access
Has API
No
API Access
Has API
No
Integrations
Rayven
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
No
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
Yes
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
Yes
iPad App
Yes
Android App
Yes
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
No
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
Yes
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
No
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
W.O. Comstock & Associates
Website
www.amrhealth.com
Vendor Details
Company Name
Riskonnect
Founded
2007
Country
United States
Website
riskonnect.com/claims-management-software/
Product Features
Claims Processing
Adjustor Management
No
Case Management
No
Claim Resolution Tracking
Yes
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
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
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