ClaimExchange Case Management Billing and Claims

Centralized Billing and Claims Management

Simplify the complexities of the billing process to ensure faster payments for providers. Caseworkers can streamline billing submissions, configure reimbursement requirements, and access real-time tracking and statuses for submitted claims.

AUTOMATE BILLING PROCESSES
INTEGRATIONS
CLAIM MANAGEMENT
MEDICAID SPECIFIC

“The standardized protocol has made it easier for the billing department and reduced duplication of entering information in Excel.”

Elevate Communications and Streamline Collaboration

CaseWorthy ClaimExchange empowers organizations with a streamlined billing solution specifically designed to speed up billing processes and ensure better claim management. Our easy-to-use web-based system eliminates the need to log into Medicaid’s portals or clearinghouses to submit claims and download remittances.

Say goodbye to manual billing processes and streamline 837-835 submissions with our CMS-compliant process. Automating billing steps reduces human-based errors and saves time so you can focus on serving individuals instead of tracking billing statuses.

Integrate with 100+ payers and create advanced Power BI Reports to show billed, reconciled, adjusted, and voided claims for a client, service, or period.

ClaimExchange Use Cases

Automate Billing Process

Save Time and Reduce Errors

Streamline your billing processes with automated billing features. Set up custom workflows for claim creation, submission, or adjustments.

  • Custom workflows to scale claim management
  • Advanced Power BI reports for claim status and more
  • Automate notifications and alerts to quickly respond to errors
ClaimExchange
ClaimExchange

Integrations

Integrate with Multiple Payers and Systems

Ensure your claims are processed correctly by integrating with 100+ payers and 80+ configurations of 837s for sending and receiving EDI transactions. Leverage our Central Identity Management system to set specific user permissions for better security settings and claim management.
 
  • Multi-payer integration and submissions for EDI transactions
  • Integration with different types of payers including state funded payers, private payers, and clearing houses
  • Central Identity Management to define access requirements and user permissions for ClaimExchange

Claim Management

One-Stop Solution for Easier Claim Management

Save time for your users by simplifying the claim management process. Our centralized system connects your billing requirements to your case management data. Speed up claim creation, submission, adjustment and get real-time statuses to ensure any errors are quickly resolved.

  • Centralized prebilling, configuration, and reimbursement features
  • Customize workflows to your organization’s specific needs
  • Intuitive, cloud-based interface to simplify claim management
ClaimExchange
ClaimExchange

Alerts and Assignments

Quickly Act on Claim Errors and Issues

Create automated alerts for claim statuses and assign the right people to quickly respond to additional needs. If claims are rejected or need modification, alert the right person to address issues.

  • Internal system alerts
  • Email notifications
  • Customizable workflows and assignments

Ready to Get Started?

Learn why health and human service organizations thrive with CaseWorthy. Our expert team is ready to consult with you on the unique needs of your organization.

Because the information lives in a single database, there’s less duplication of records and profiles,which helps to increase efficiency across multiple organizations working together to help those who need it.

Director of Information Technology, CAP of Lancaster

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