Claims Processing

We administer medical, dental, vision, prescription and disability claims with a fully automated software system which is continually enhanced by our staff of computer programmers. All claims are computer scanned for immediate document retrieval and eligibility determination prior to adjudication.

Our services include but are not limited to the following:

  • Anthem JAA claims administration platform
  • Integration of Large Case Management, Precertification and Concurrent Review
  • On-line Claim Review and Adjudication
  • Parameter-driven system to accommodate any benefit plan design
  • PPO, EPO, Triple Option access through local or national networks
  • Excellent claims turn around time
  • Receive and adjudicate claims through Electronic Data Interchange
  • Daily in-house Internal audits of claims processing personnel
  • Annual Audits conducted by CPA firms continually rate our services as excellent
  • Customized complete detailed claims reporting is available. Reporting is available for but not limited to: detail by employee or dependent, type or nature of claims, procedure, diagnosis, provider, service or patient location, PPO/EPO utilization, COB savings and large claim identification.

Emdeon Healthcare Payment Network

Questions About Enrollment?
Providers may contact the Emdeon Support Team by calling (866) 506-2830, option 1.