The Best Value in Prepay Claims Editing
The Best Value in Prepay Claims Editing
With nearly 20 years of industry-leading experience, ClaimInsight by AMPS has redefined the standards of payment integrity. Our solution is built on a legacy of innovation and dedication to healthcare payors, delivering unmatched accuracy and efficiency in every claim review.
Offering industry-leading healthcare payment integrity solutions that maximize accuracy and reduce costs; our robust state-of-the-art claims editing technology (IPU) combined with a best-in-class physician-led Medical Bill Review (MBR), ensures claims are processed efficiently and accurately, delivering exceptional savings and innovative Payment Integrity.
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Are you ready for a better way?
Innovation + Operational Efficiency
Through our robust prepay claim editing library and our advanced automated rules engine, ClaimInsight edits claims with unmatched speed and accuracy, effectively reducing overpayments and minimizing administrative expenses.
Designed to integrate seamlessly with existing claims editing platforms, whether before or after implementation, you can trust in a solution that not only drives financial success but also ensures operational excellence.
Key product components
Automates payment policy rules to reduce medical spend without high contingency fees.
Be able to attract top-tier candidates to join your team and help build your biz.
Extensive and robust editing library surpasses competitor offerings.
A comprehensive Medical Director review of high-dollar complex claims.
Line-by-line itemized reviews that uncover inappropriate use of modifiers and other billing inaccuracies.
Intelligent Policy Update
(IPU)
Medical Bill Review
(MBR)
Advantages of ClaimInsight
Advantages of ClaimInsight
Explore how ClaimInsight's industry-leading solution drives significant savings, enhanced accuracy, and streamlined operations.
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Through our robust prepay claim editing library and our advanced automated rules engine, ClaimInsight edits claims with unmatched speed and accuracy, effectively reducing overpayments and minimizing administrative expenses.
Our solution saves our clients an average $5,000,000 per 100,000 members annually.
Introducing...
innovative
claims editing
Focusing on accuracy, ClaimInsight uses comprehensive and defensible payment policies to minimize provider abrasion and guarantee precise payments. This blend of automation, integration, and thorough review makes ClaimInsight the top choice for payors seeking enhanced value and operational efficiency in prepay claims editing.
how we achieve
Meaningful Savings.
Lower cost.
01
Research
Physicians and coding experts review and discuss to ensure accuracy and optimize savings opportunities.
02
Execute
Experts codify our payment policy library to incorporate pattern recognition and predictive analytics.
03
Automate
Maximize value through automation and comprehensive physician review based on a client-determined threshold.
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Why ClaimInsight?
Integrated into the core admin claim system, ClaimInsight excels in efficient and precise claims processing by leveraging advanced automation and comprehensive physician reviews to optimize savings and ensure accuracy.
Seamless integration into core administrative systems streamlines operations and minimizes administrative costs.
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$8.5M
Savings with a 160K life Medicaid Plan
$20M
Savings with a 500K life employer plan
69.5%
Savings on in-network reviews
7.5%
Savings on out-of-network reviews
Unlock significant savings in medical spend and administrative costs
Ready to take control of your healthcare costs? Our cutting-edge solution not only delivers unmatched accuracy in claims editing, but also significantly reduces medical spend while streamlining administrative processes. With our lower contingency fees, you can optimize savings across the board.
Partner with a vendor who prioritizes precision, efficiency, and cost-effectiveness. Reach out today to discover how we can help you achieve measurable results while reducing your overall spend.
