AdjudicatorCervey
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Complete ClaimsComplete Health Systems
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Related Products
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Adjudicator:
About
Adjudicator is a plan management and prescription claims adjudication platform for pharmacy benefit managers, health plans, hospitals and health systems, pharmacy programs, managed care organizations, manufacturers, and retail pharmacies. It supports configurable plan designs and benefit structures, multi-tenant environments, pharmacy network configurations, and management of drugs, formularies, and maximum allowable cost (MAC) pricing. Its member portal provides real-time benefit-status and pending-claim tracking, secure document uploads, and notifications. A prior authorization dashboard provides access to claims data and secure communications. An API framework supports data exchange with internal processes and external business partners. Adjudicator helps organizations manage pharmacy benefits and prescription claims.
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Complete Claims:
About
Claims Adjudication for medical, dental, vision, prescription, short and long-term disability claims. Available for on-site license or as a hosted application (ASP). Microsoft technology: SQLServer database with a Windows front end. Acclaimed Customer service staffed by health care claims experts with a minimum of 12 years’ experience in the field. Support calls are logged with status available via the internet. Plan copy and modification feature enable quick setup of plans. Auto-adjudication using benefit codes built using business rules based on over 25 variables from both the claim and the claimant records made available to the adjudication engine. Inbound claims can be scanned images, EDI or paper. HIPAA EDI 5010 transaction sets. Re-pricing fee and UCR Schedules can be loaded on the system in advance of the effective date. The date-driven logic will re-price based on the date of service.
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Adjudicator:
Platforms Supported
Windows
Not Supported
Mac
Not Supported
Linux
Not Supported
Cloud
Supported
On-Premises
Not Supported
iPhone
Not Supported
iPad
Not Supported
Android
Not Supported
Chromebook
Not Supported
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Complete Claims:
Platforms Supported
Windows
Not Supported
Mac
Not Supported
Linux
Not Supported
Cloud
Supported
On-Premises
Not Supported
iPhone
Not Supported
iPad
Not Supported
Android
Not Supported
Chromebook
Not Supported
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Adjudicator:
Audience
Prescription Benefit Managers (PBMs), Third-Party Administrators (TPAs), Self-Funded Employers, Health Plans, Hospitals & Health Systems, Pharmaceutical Manufacturers, Cash & Discount Card Sponsors, Retail Chain Pharmacies
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Complete Claims:
Audience
Businesses in need of a tool to manage their claims adjudication processes
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Adjudicator:
Support
Phone Support
Supported
24/7 Live Support
Supported
Online
Not Supported
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Complete Claims:
Support
Phone Support
Supported
24/7 Live Support
Not Supported
Online
Supported
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Adjudicator:
API
Offers API
Supported
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Complete Claims:
API
Offers API
Not Supported
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Adjudicator:
Screenshots and Videos |
Complete Claims:
Screenshots and Videos |
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Adjudicator:
Pricing
No information available.
Free Version
Not Supported
Free Trial
Not Supported
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Complete Claims:
Pricing
No information available.
Free Version
Not Supported
Free Trial
Not Supported
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Adjudicator:
Reviews/
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Complete Claims:
Reviews/
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Adjudicator:
Training
Documentation
Supported
Webinars
Supported
Live Online
Supported
In Person
Supported
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Complete Claims:
Training
Documentation
Not Supported
Webinars
Not Supported
Live Online
Not Supported
In Person
Not Supported
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Adjudicator:
Company InformationCervey
Founded: 1978
United States
cervey.com
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Complete Claims:
Company InformationComplete Health Systems
completehealthsys.com/claims/
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Adjudicator:
Alternatives |
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Adjudicator:
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Complete Claims:
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Adjudicator:
Integrations
No info available.
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Complete Claims:
Integrations
No info available.
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Adjudicator:
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Complete Claims:
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