PayerFusion’s Medical Claim Processing System utilizes Intelligent Technology to make you the expert

Our TPA Software Ends the Guessing Game of Claims and Policy Management

The technology and knowledge based enterprises created and employed by PayerFusion allows us to provide you with the most accurate and up-to-the minute information regarding your healthcare policy performance. Our medical claims processing system analyzes and evaluates millions of compiled claim transactions to generate accurate reports and reliable informatics which allow our clients to compare their healthcare policy performance to other U.S. payers, large and small. Our comprehensive suite of claim processing tools can be configured according to your needs, in a fully compliant HIPAA environment.

Our clients are one mouse click away from access to medical claims surveillance, case file investigations for fraud and abuse, plan analyzers, predictive modeling, tools for cost projections and plan design analyzers. Our TPA software is a web enabled communication platform enhances accuracy in decision making by dramatically increasing the speed in which valid and reliable information is shared. At PayerFusion, we make sure tools for success are easily accessible for all of our clients. Our pioneering technology augments risk management by: (1) providing financial and clinical early alert predictors and (2) profiling chronic diseases and potential catastrophic claimants.

Our clients enjoy a technological advantage which includes:

Enterprise-class web application

  • Accessible via the Internet
  • Remotely hosted at a hardened data center
  • 99.9% guaranteed up-time
  • Utilizes 128-bit encryption (SSL enabled)
  • Open interfaces to integrate with legacy systems
  • Multi-language support/multi-time zone
  • Multi-currency real time conversion
  • Handles sophisticated client business configurations
  • Role-based security
  • Developed using open-source technologies
  • Friendly user interface
  • Leverages strong:
    • Workflow components
    • Transaction processing

Coming Soon: Mobile Devices

 

Healthcare Mobile App

  • Provides both payer and partner facing applications
  • Secure information delivery and capture
  • Business intelligence and executive information
  • Allows for unstructured data capture such as voice and photos
  • Distributed via iTunes App Store or Blackberry Application