Adjudicate every single claim
Claims administration is at the heart of every successful healthcare plan - receiving, logging, adjudicating against approved standards and making accurate payments or reimbursements. Accerta has been adjudicating claims since 1958.
Adjudication can make or break the viability of a benefits plan. With Accerta, every claim is professionally adjudicated according to the terms and limits specified by each plan. Accerta saves employers nearly 10% of the cost of claims submitted by screening out excess or unnecessary charges. The savings help to manage plan costs.
Accerta has a multi-level fraud and abuse detection system:
- Highly sophisticated adjudication rules to weed out suspect claims
- Searching for claim patterns, i.e. claims are compared against a database to identify suspect behaviour
- Regular profiling of top billers
The end result is confidence and ongoing cost-control.