Claims Configuration

Gain Efficiencies Through Smart Claims Configuration

Gain Efficiencies Through Smart Claims Configuration

– Specialized in health plans with broad and deep industry experience

– Diversity-certified, woman-owned business

– Turnkey staffing, training, supervision, technology, and more

– Flexibility and agility to meet your unique needs

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Achieve lower operational costs and fewer pended claims, while improving claims payment accuracy– Health plans with well-designed configuration can achieve lower operational costs, improved claims payment accuracy, and fewer pended claims – all important for provider and member satisfaction.

Changes to the marketplace drive health plans to introduce new products and enter new lines of business. This creates new business rules which drive changes to configuration and many health plans struggle to keep pace.

Catalyst’s IT consulting and outsourcing services can help you meet your operational efficiency goals. Catalyst has extensive experience working with all major claims platforms and can transform your configuration to meet your plan’s unique needs.

Catalyst can help you with:
• Design and build configuration
• Optimize business rules
• Lead system implementations and upgrades
• Optimize/re-design configuration
• Provide configuration supplemental staff

Catalyst backs our performance with service level and financially based performance guarantees

Catalyst invests time in understanding your unique processes, procedures, and technologies
Every healthcare plan is unique…
In order to provide accurate pricing, Catalyst invests time in a two-week pricing process to understand how all your key differentiators affect how you do business.

Example of Configuration Service Level Agreements:
Turnaround time on Update Requests:
• Tickets resolved within 30 days =70%
• Tickets resolved within 60 days = 85%
• Tickets resolved within 90 days = 95%

Why Work with Catalyst Solutions?
Our mission is to help health plans improve healthcare outcomes, drive down costs and optimize revenue. Catalyst Solutions is exclusively focused on the needs of health plans with unmatched depth and 20+ years of specialized industry experience including outsourced BPO, IT, and consulting services. As a diversity-certified, woman-owned company based in the U.S., we offer agility and flexibility to provide comprehensive solutions to meet your unique needs.

Learn more about why Catalyst’s claims configuration consulting service makes good business sense.

Contact us to get a quote