Complete Claims

Complete Claims

Complete Health Systems
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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.

About

Garner delivers a data-driven platform that enables individuals, employers, and health plans to identify top-performing medical providers by leveraging one of the largest claims databases in the U.S., over 60 billion records covering more than 320 million patients. It uses more than 500 specialty-specific quality and efficiency metrics to analyze provider performance and diagnose outcomes, and a verified directory powered by AI that achieves approximately 92% accuracy for provider phone, address, and appointment-availability information. Providers flagged as “Top Providers” meet rigorous criteria, including evidence-based treatment, minimized unnecessary procedures, and efficient cost structures. Members can use a mobile app and concierge service to locate in-network Top Providers with available appointments, and when eligible, have certain out-of-pocket costs reimbursed for services rendered by these providers.

Platforms Supported

Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook

Platforms Supported

Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook

Audience

Businesses in need of a tool to manage their claims adjudication processes

Audience

Employers, health plans and care-navigation teams interested in a tool to steer members toward high-quality, cost-efficient providers and improve referral decision-making

Support

Phone Support
24/7 Live Support
Online

Support

Phone Support
24/7 Live Support
Online

API

Offers API

API

Offers API

Screenshots and Videos

Screenshots and Videos

Pricing

No information available.
Free Version
Free Trial

Pricing

Free
Free Version
Free Trial

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

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Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Training

Documentation
Webinars
Live Online
In Person

Training

Documentation
Webinars
Live Online
In Person

Company Information

Complete Health Systems
completehealthsys.com/claims/

Company Information

Garner
United States
www.getgarner.com

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Categories

Categories

Integrations

No info available.

Integrations

No info available.
Claim Complete Claims and update features and information
Claim Complete Claims and update features and information
Claim Garner and update features and information
Claim Garner and update features and information