Conduent’s HSP comprehensive Core Claims Administration solution is specifically designed for healthcare Payers and Third-Party Administrators. It speeds the processing of complicated healthcare claims by utilizing a broad range of embedded automated tools. We don’t merely assume the burden of your data entry; we apply user-defined rules, workflows and document management tools to optimize the overall process.
The benefits and claims administration solution is built with touch free claims processing in the forefront as the rule and not the exception. The flexible user-definable claims adjudication engine and inherent enterprise workflow supports medical, dental, vision and specialty health benefits administration for multiple lines of business including commercial, Medicaid, Medi-Cal, and Medicare Advantage, all on a single instance of the application. The system automates traditionally manual labor-intensive functions across the enterprise including the management of:
The system’s flexible adjudication engine, real-time workflow and the comprehensive database of rules enable highly comprehensive auto-adjudication capabilities that have been proven to optimize claims auto-adjudication rates to exceed industry recommended standards while lowering overall operational costs.
HSP Core Claims Administration allows you to:
