Product

Healthcare Encounters and Claims Processing

Access a best in KLAS platform for capturing maximum encounter data quality and quantity

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Get the data and analytics you need to succeed with medical claims processing.

Risk sharing or value-based payment models introduce a whole new set of challenges for health plans. Since payment is not directly tied to “capitated” or managed care data submission, the quantity and quality of the data is at risk. We fill that gap with our best in KLAS platform for managing encounters and claims processing.

For more than 25 years, TransUnion has delivered encounters and claims processing to managed care health plans. Our ClearIQ® platform leverages that experience to deliver a single solution for processing claims and encounters data, along with features designed specifically for value-based payment models, including mass error correction, auto archiving and transparent payer reporting.

PRODUCT HIGHLIGHTS
  • Access to maximum encounter data quality and quantity for HEDIS, risk adjustment, STARS, P4P and contractual reimbursement determination

  • Improved data throughput rates by applying payer-specific edits, custom submitter rules, member validation, and more

  • Multi-level payer dashboards for high level reconciliation and enhanced transparency over your data

  • High-touch customer support—we go above and beyond the call of duty for our customers

  • Increased submitter satisfaction with our Best In KLAS submitter portal, which offers mass error correction and auto archiving—features available only through TransUnion

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