TPAS AND HEALTH PLANS
Many groups. Different rules.
Celerity configures a different claim path for every employer group inside one platform, upstream of the adjudication system you already run.
Every custom strategy used to mean a new workflow.
One group wants a regional network. Another wants direct contracts. A third needs reference-based pricing. Traditionally each one adds a vendor, a file feed and a manual process your team maintains forever. With Celerity, new strategies get quickly configured, not built.
How it works
Claims arrive in X12 format
EDI 837 and paper through mailroom and OCR. Payer ID setup and multi-group acquisition into one workflow.
Eligibility resolves in real time
Eligibility verified, member lookup, plan validation and coverage check. Scrubbing raises autopre-pricing rates.
Each group's rules apply
Network hierarchy, provider, geography, line of business and claim type decide the path and the price.
A cleaner claim reaches adjudication
Validated 837/835 delivered to your platform, with claim status and savings visible in the portal.
Employer group
Geography
Claim type
Provider
Line of business
Network strategy
Benefit structure
Pricing methodology
Different groups. Different claim paths. One engine.
How clients use Celerity today
Your claims system stays
Celerity runs upstream of adjudication. Nothing about your core platform changes.
Rules live at group level
One client's exception doesn't become a workaround your whole team maintains.
Start anywhere
Clearinghouse functions alone, the network stack, or the full pre-adjudication workflow.
120+ connections already built
New networks and groups start from existing connectivity, not from zero.