PayerFusion’s innovative approach to medical claims processing and health plan administration results in synergistic relationships between payer, provider and patient.

Our services improve payers’ control over their internal processes, reduce the costs of medical claims and health plan administration. Our unique approach includes a strong emphasis on provider relations and improving patient satisfaction with the process of accessing quality care.

• Better Provider Options - Our network is without walls. No quality provider is excluded, and top performing providers are ranked (by quality and cost) to help you make informed choices.
• Savings - Our innovative medical claims processing and cost-plus pricing methodology results in superior cost containment, helping you to control the average cost of your medical claims now and over time.
• Compliance and Peace of Mind - We provide you with expertise and thought leadership so you can stay current with constantly changing state and federal rules and regulations as the U.S. healthcare system continues to evolve.
• Case Management and Utilization Review – Concurrent review of episodes of care to avoid unnecessary medical expenses while ensuring necessary and appropriate treatment.
• Unparalleled Customer Service – We have a culture of excellence. Adhering to ISO and Six Sigma Standards, we aim for 100% patient, payer and provider satisfaction.

Learn more about our services for payers, for providers and for patients.