Overview

We have deep expertise in managing specialized claim processes in all lines of business. We can work on your platform or ours. And we can deliver where and when you need it – from managed services to surge projects and overflow support.

Claims Administration

While most of our work is done post-payment, we can handle the entire spectrum of claims administration functions. We work on any platform and utilize a combination of propriety and client tools to meet the needs of each health plan.

Our clients typically deliver the initial training, give us remote access into their applications, provide us with productivity and quality goals, and we take it from there. Since our agents average 5+ years of Tier 2 and Tier 3 claims experience, we can ramp up quickly and with a high standard of quality. Our work ranges from simple pend resolution to high-dollar institutional recoveries. We can provide services on a surge, overflow, or outsourcing basis.

Systems we Support

  • DST® (AMISYS™, PowerMHS™)
  • TriZetto® (QNXT™, Facets™)
  • Perot® / Dell® (Diamond™, XCELYS™)
  • HealthEdge® (HealthRules™)
  • Plexis®
  • HP®/ EDS® (MetaVance™)
  • WELLPoINT WGS
  • Other proprietary

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Cost Containment

Working hand-in-hand with our strategic partners, we provide a full lifecycle cost containment solution. We are a technology-enabled payment integrity vendor offering a robust suite of overpayment auditing capabilities. These services cover both physician and facility claims, including in-patient and outpatient services.

BroadPath provides an in-depth and comprehensive blend of data mining and clinical review capabilities in a seamlessly integrated workflow. This spans both pre- and post-pay and automated and complex review strategies that are driven by each customer’s unique provider statistics.  This functionality allows our clients to experience the maximum amount of savings with the least amount of process disruption and impact to providers.

 

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Get started today.

Find out what BroadPath can do for your organization.

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