Despite millions invested in complex auto-adjudication systems, payers continue to have to manually interpret and troubleshoot common claim submissions, inaccurate payments, and member complaints.
Practical, Modular, Interoperable Solutions
Claims administration systems are incredibly complex investments that have been built up over years. While 88% if payers report being dissatisfied with their current systems, most feel that the cost, complexity, and risk to replace their systems outweigh the risks. Advalent understands that payers need practical, incremental solutions that don’t disrupt their business. Advalent takes the unique approach of opening up our systems for integration with anyone. We don’t see other vendors as competitors but as important collaborators in creating solutions that work for our customers.
Codified Smart Contracts that Drive Payments
With contracting siloed from payments, payers must invest in complex processes to translate contracts into rules that automated systems can recognize and execute on. Advalent changes the equation by embedding rules directly into your contracting process. Instead of starting with a complex legal document, Advalent customers start by defining the rules that govern payment and compliant legal documents are automatically generated and kept up to date from within the payment processing system.
Providers love the simplicity and control of finally understanding how they will be paid. Payers love the reduction in errors and ambiguity!
Rich & Accurate Provider Data
Accurate claims administration relies on accurate provider data to accurately, filter, assign, and apply payment rules. By integrating provider directory management services with core administration systems, Advalent eliminates the most significant bottleneck to accurately paid claims.