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Claims Management and Admin Solution

With escalating cost of healthcare and the demand for new and innovative products, administrative and cost efficiencies have become imperative for healthcare payers. Our focus is on creating savings that will help you offset your cost of delivering affordable quality outcomes.

Our Claims Management and Admin Services have a track record of doing just that, with a range of services using HIPAA compliant processes within our state-of-the art service centers. We enable you to increase your claims administration efficiency while materially decreasing your costs and stabilizing your claims operation.

We provide significant and tangible results by combining our extensive domain knowledge, business rule engines, and a best-in-class operating model.

Our Mail-room Services, Member Enrollments, Reports Management, Grievance Handling and Refund Posting, Customer Services, and Claims Processing solutions allows you to focus your time and energies on member acquisition and on other critical business growth priorities.

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Client Thoughts

"The dedication from our e4e teams to provide the best possible services is beyond comparison."

"We are amazed and pleased with…the difference the e4e team is making to our inventory levels."

"All work being performed by you is good and very well appreciated."

"We really appreciate all that you do to help make us a better company and increase our business's revenue."

"e4e continues to be a key player in the success of our company."

"They are very accurate in their work and are very responsive to our changing needs."

"By utilizing your services, we are able to focus more on our client and strengthen our core delivery."

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Provider Solutions

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Benefits of e4e's Claims Management and Admin Services

  • Accurate, appropriate, and timely payments with regulatory compliance
  • Over 300 claim analysis and HCC coders on Medicare/Medicare Advantage/Medicaid health insurance providers
  • Experience in over eight payer platforms
  • 6.4 million claims processed per year with consistently over 98% accuracy

Why Choose e4e's Claims Management and Admin Service

e4e provides an end-to-end Claims Management Service that supports:

  • 6.4 million claims adjudicated per annum
  • $1.3 billion paid on claims
  • $4 million recovery on wrong bills
  • One-stop shop for software and services
  • Over 22 years of operational and domain experience
  • Handle Medicare and Medicaid HMO and commercial plans
  • Very high financial and payment accuracy
  • Ability to interface with legacy systems, multiple vendors/systems to protect existing investment
  • Structured and professional transition and implementation program
  • Highly experienced healthcare management team