Claim Repricing
To achieve the highest level of efficiency and accuracy, payors must eliminate as many manual processes as possible. Physicians Health Collaborative is able to automate claim pricing through our claim pricing vendor, Innovative Resources for Payers (IRP).
IRP maintains a HIPAA-compliant electronic data interchange (EDI) program to manage receipt, delivery and exchange of claims and claim data.
Through IRP Physicians Health Collaborative is able to:
- Achieve pricing automation at 99.8 percent for clean claims with valid provider identification
- Clean electronic claims can process in as little as six hours
- Paper-claim conversion to EDI processing
- HIPAA compliance for all claims through EDI processing
- Clearinghouse connectivity through Emdeon
- Automated entry of claims into the system
- Automated provider matching
- Automated group/eligibility verification
- Automated receipt, delivery and exchange of claims
- Real time claim information through online access to all network claims
Physicians Health Collaborative, an affiliate of HealthSpan, LLC ·
2200 Jefferson Ave, 4th Floor ·
Toledo, OH 43604