Context 4 Health Plans Suite
Protect the integrity of your health plan and determine accurate pricing with the Context4 Health Plans Suite, our modular, cloud‑based technology platform. Immediate, actionable, and defensible Fraud, Waste, and Abuse (FWA) detection built by our team of certified clinical, dental, and health benefits experts. Accurate data and cutting-edge cloud technology combine to create a proven and defensible medicare reference-based pricing (RBP) solution. More than 100 healthcare data sets, with professional support to optimize efficiency and compliance. Advanced medical coding software designed to expedite claim submission and minimize denials. Our cloud based Payment Integrity Platform utilizes our proprietary analytics engine to identify coding errors, medical necessity, unbundling, fraud-waste-abuse, audit risks, pricing and other aberrations that can impact your business.
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Guidewire ClaimCenter
Guidewire ClaimCenter is a leading claims management system designed to streamline the entire claims lifecycle for property and casualty (P&C) insurers. It offers comprehensive functionality from initial claim intake to resolution, enabling insurers to process claims efficiently and accurately. Key features include automated workflows, embedded analytics, integrated fraud detection, and real-time performance monitoring, all of which enhance operational efficiency and improve customer satisfaction. ClaimCenter supports various lines of insurance, including personal, commercial, and workers' compensation, and can be deployed as a standalone solution or as part of the Guidewire InsuranceSuite. By leveraging ClaimCenter, insurers can accelerate claims processing, make data-driven decisions, and adapt to evolving market demands.
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MediConCen
The ultimate insurance claim automation solution powered by patented blockchain technology. Claims are the moment of truth for all insurance, and with our solutions, everything has been craftily designed to automate insurance claims for insured and insurers with unbeatable accuracy and speed, from claim estimation before a claim occurs, to making the right claim decision and settling the payments. MediConCen is a leading insurance technology that automates insurance claims and makes insurance usable for insurance companies, medical networks, and clinics using Hyperledger Fabric blockchain. We empower claim assessors with powerful AI models and expert knowledge decision rule engines so that fraud and abuse can be spotted instantly and clean cases can be approved right away for consistently perfect claim cost management and unbeatable efficiency. Be in the know with powerful claim analytics that simply work for underwriting and product development.
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Cloud Claims
Improve claim outcomes with streamlined First Notice of Loss (FNOL), claim processing and flexible reporting.
INCIDENT BASED CLAIMS MANAGEMENT
Effective claims management is about more than simply managing claims outcomes. It is about having an automated process that ensures efficiency and accuracy across the organization, getting timely notice of losses, and taking swift action are keys to success. The incident-based approach of Cloud Claims covers all accidents and losses, delivering a complete picture of loss to executives and claims managers.
Cloud Claims by APP Tech is an integrated solution that is highly configurable, with actionable reports to guide decision-making and a friendly UI so you can get work done faster and more confidently.
Cloud Claims runs in the cloud, so there’s minimal IT burden and no installation required — just simple configuration, effortless system upgrades, best-in-class security, and the ability to scale quickly.
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