Health Claim
Management
System
Mazecare provides the complete integrated solution for health insurance claims
Build your own health claim management system
Claim adjudication engine fetches insurance policies and previous approved claims to approve new health claims.
Insurance Policy
Claim to verify
Previous Claims
Claim Verification Request
Approved
Insurance
Policy
Claim to Verify
Previous
Claims
Claim Verification Request
Approved
Our Health Claim Management Platform ensures that every claim is screened against insurance policies and previous claims. Claims that are flagged as potential problems are included in detailed worklists and carrier specific information. Hours of time is saved in tracking appeals, resubmissions and searching up notes for claims that require additional information. Our Health Claim Platform ensures faster and accurate reimbursement for health providers and issuing of patient bills promptly leaving the insurance company with fewer outstanding pending claims.
Core
Features
How it all comes together with endless combinations and customizations
Rule-based
Our platform utilized a rules-based engine to create Health Policies that include conditions, limits, cost-sharing parameters, and more.
Multiple policies
Our Health Claim Platform ensures that you can work with multiple policies or single policies.
Tracking Claims
Easily keep track of claims that have been submitted along with the outstanding benefits amounts, limits.
Claims Screening
Our platform analyses the data and detects and flags any over-treatment and overutilization to avoid additional costs from incurring. We can easily help you avoid overmedication problems and protect you against fraudulent claims.
Payment Agreements
Create cashless / co-payment flows with health providers
Contracts Management
Manage contracts between provider and payor
Connectivity with APIs
Powered by APIs , the ultimate business tool, we can also connect to any internal systems that you may have.
Multiple Devices
Deployable anywhere, any platform, on the cloud or on premises
Mazecare is the best place
to put your trust in.
Custom Design. One Platform. Multiple Devices.