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

Riskonnect Claims Management Software is a comprehensive platform designed to streamline and automate the entire claims lifecycle from intake through final settlement. The software centralizes claim data, workflows, and communications into a single system that improves visibility and operational efficiency. Organizations can automate routine tasks, reduce manual work, and accelerate claims resolution with configurable workflows and intelligent claims processing tools. The platform supports features such as electronic injury reporting, reserve management, adjudication, subrogation, recovery tracking, and return-to-work management. Riskonnect also integrates predictive analytics, machine learning, and AI capabilities to help claims professionals identify risks, forecast claim outcomes, and improve decision-making. Real-time collaboration tools allow adjusters, stakeholders, and third parties to work together more effectively while maintaining compliance with industry regulations.

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

Riskonnect Claims Management Software is designed for insurance companies, third-party administrators, risk managers, healthcare organizations, and enterprises seeking to automate and improve complex claims management operations

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

No information available.
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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Review this Software

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

Riskonnect
Founded: 2007
United States
riskonnect.com/claims-management-software/

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Categories

Categories

Integrations

Rayven

Integrations

Rayven
Claim Complete Claims and update features and information
Claim Complete Claims and update features and information
Claim Riskonnect Claims Management and update features and information
Claim Riskonnect Claims Management and update features and information