PayerFusion provides a full range of health plan administration, cost containment and medical claims management services to self-funded employers, international insurers and assistance companies. We employ a proprietary cost-plus pricing methodology and access to our privately owned provider network to secure the greatest savings possible for our client partners. Our unique approach includes a strong emphasis on provider relations and improving patient satisfaction with the process of accessing quality care.
Full-service medical claim processing and administration solution customized to meet your business requirements.
Our highly effective medical case management service reduces billing errors, facilitates prompt payment to providers, maximizes opportunities for savings and ensures that patients are receiving the appropriate care.
PayFuseNet is our proprietary provider network that gives our clients access to maximum savings and high-quality healthcare providers. Fully compliant with US regulations, Payfusenet has an established presence across the USA, Puerto Rico, the Caribbean, Latin America, Europe, Asia, New Zealand and South Africa. Networks in development include Egypt, Turkey, India and China.
State-of-the-art solutions to support every aspect of health plan administration including online provider search, claim portals and mobile applications.
Our unique Cost-Plus Pricing Methodology assesses each claim compared to national data in order to determine fair reimbursement based on the actual cost of service.
Providing your members with specialty services can be a strong differentiator in a competitive market. Services include Second Medical Opinion, White Glove Service, Medical Escort and House Call.
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