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Claims Processing and Recovery

Flexibility and power for your enterprise

To the insured, when it comes to claims it’s all about speed.  For the insurer, it’s all about volume and accuracy.  Insurers know that small changes in policies can have significant effects on their business, positively or negatively.

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Corticon's advanced technology makes your systems smarter and your processes faster with greater accuracy. Our high-performance scalable server will keep up with your most demanding performance needs.

  • Data Enrichment
    • Pre-process raw claims data to improve accuracy
    • Create your own value-added member and provider matching routines without programming
  • Claims Re-pricing
    • Realize huge savings on network fees with direct contracts
    • Create new pricing arrangements without special programming
  • Auto Adjudication
    • Identify a subset of claims for special rules-based processing
    • Perform sophisticated examination of claims without modifying your existing claims system
    • Automatically document each claims decision
  • COB and Subrogation
    • Automate selection of candidate claims for COB processing and access related experience data
    • Automate extract and analysis processes to accelerate recovery actions
  • Examiner Controls
    • Rules integrate with your workflow system to provide enhanced control
    • Changes in work assignments and authority levels can be reflected in minutes

Claims Processing and Recovery Solution Benefits Summary

  • Increase the value of enterprise applications by extending their functionality
  • Quickly adapt to changing conditions with rules-based processes
  • Lower administrative costs due to manual processes and re-work

Related Products:Corticon Business Rules Modeling Studio, Corticon Business Rules Server, Corticon Dialogs

Additional Corticon Healthcare Solutions: Offer Management, Eligibility and Enrollment, Marketing, Policyholder Servicing and Compliance, Sales and Underwriting

To speak with someone at Corticon, please contact us here, call us at +1 888.619.2424 or email us at info@corticon.com.