Preferred Provider Organizations

To stay competitive in today’s healthcare market, PPOs must constantly focus on offering superior services at competitive prices. One key to offering superior service is to support a superior network of providers, one which attracts employers and providers alike. The key to keeping costs down is to manage this network of customers and providers optimally. ClaimsBridge helps PPOs in both of these tasks.

PPOs who use ClaimsBridge can easily extend their network to include new providers, repricers and TPAs, thus offering new services to potential new customers. With ClaimsBridge as the connecting tool, each entity in the health network recognizes economies of scale, making each entity more responsive to its clients and more cost effective.

ClaimsBridge eases the claims adjudication process for PPOs by extending the power of a PPO’s IT department. Working in conjunction with existing systems, ClaimsBridge adds powerful new features such as the use of standard or proprietary EDI claim formats, claim scrubbing, and repricing.

PPOs must apply a number of business rules and checks for every claim they process. ClaimsBridge helps PPOs manage and perform these functions efficiently.