More Automated, More Accurate Payment

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Increasingly complex plans, plus more and varied lines of business, can push healthcare payers' claims payment systems beyond their ability to deliver the necessary speed and accuracy.

ClaimsXten combines the strength and flexibility of the web2pro Total Payment™ platform, a comprehensive library of web2pro clinical rule content, and a services team of medical claims experts to provide your organization with more medical and administrative savings opportunities. With full-service, technologically advanced ClaimsXten, you can do much more than standard fee-for-service claim code editing.

Providing Flexibility to Increase Efficiency

With ClaimsXten, you can apply edits to claims at any point in your workflow. This means you can automate and manage the unique requirements for varied claims management policies and medical payment policies. Delivered as a full service ASP solution securely hosted by web2pro (or customer-hosted with a customized service path), with ClaimsXten you can:

  • Increase your auto-adjudication rates
  • Adjudicate ICD-10 claims with rules that look at historical claims coded in ICD-9
  • Consistently and accurately apply your policies - across plans, regions and claims processing systems
  • Pay claims more accurately while reducing administrative costs
  • Shift processing burdens to extend the useful life of your claims processing system(s)

Providing Comprehensive Clinical Editing Content

Our continuously growing body of clinical editing rules, along with the extensive rule customization flexibility of ClaimsXten, help you manage medical and payment policies across all lines of business and for both professional and facility claims. In addition to the standard industry edits, the seasoned web2pro Clinical Team also develops and maintains clinically sound, sourced rules specifically covering the following areas:

  • National Coverage Determination/Local Coverage Determination
  • CMS-Sourced
  • Medical Policy
  • Waste and Abuse themes
  • Specialty Pharmaceuticals
  • Featured Video - How ClaimsXten Solves Problems

    Ann Marie Apruzzi of Horizon Healthcare Services of NJ speaks to the value of ClaimsXten