IntelliClaim Selected by Several Health Plans to Help in Claims Review Optimization Initiatives

IntelliClaim, an industry provider in healthcare claims performance technology, announced its selection by four health plans to help in their claims review optimization initiatives.

Independent Health Association in Buffalo, New York; Community First Health Plans in San Antonio, Texas; Health New England in Springfield, Massachusetts; and Preferred Health System in Wichita, Kansas, reportedly chose IntelliClaim’s claims performance solution of Enhanced Claims Editing suite due, primarily, to IntelliClaim’s ability to provide greater flexibility, transparency and effectiveness to their plans’ operations, members and providers.

“We are very excited at the opportunity to partner with our new clients in their efforts to improve the value chain to their stakeholders — internal staff, members, providers and employer groups,” said Kathleen Connolly, IntelliClaim president. “Our Claims Performance solutions facilitate greater flexibility, accuracy and consistency in a health plan’s claims processing workflow by combining our leading technology with industry-savvy professionals to help clients get real-time, actionable intelligence for making better operational decisions,” she added.

The solution reportedly enables significant flexibility to change business rules as governed by new policies, provider contracts and state or federal regulation or legislation. This allows health plans to react more quickly to changing needs, and process claims more effectively.

In addition, the solution affords plans a higher level of transparency, enabling clear and complete explanations of how each specific claim was processed, and what rules were applied. The plans anticipate improved provider and member satisfaction from the improved consistency made possible by greater automation, and the enhanced accuracy achieved via the flexible technology.