Established in 1997

Since our inception we have served a wide variety of clients including law practices, private physicians’ practices, large hospital organizations, and the nation’s biggest payers. Some of our clients include: Anthem Blue Cross, Sutter Health, Sharecare, Stanford Health, New West Health, John Muir Health, Washington Hospital health Systems, Moses – Cone Health, Equian.

Our associates, subcontractors, vendors, and channel partners have a wide variety of experience both within and outside of the healthcare industry. We have a modest, honest approach to your project resolution. We use Claim WRX™, The industry’s leading Denials Management Solution and Audit Tracking System. The application was meant to to contain costs in Denials Management, and then using a reporting methodology, we begin defining at ever increasing granular levels, the “root cause” of your denial and its ultimate resolution.

Our proprietary SaaS cloud-based workflow tool intended for the many types of “audits” that occur within the industry. As this is our primary source of business, we are very familiar with the needs and shortfalls many companies experience in this realm. To be frank, we have a better solution for the quick and concise review, and data tracking of audits. Because we are cloud based you can audit from your laptop, tablet, or even phone and Claim WRX surpasses all the standards set by HIPAA-HITECH. We offer all types of medical audit, virtual 24/7 case management, trauma abstraction, and a wide variety of revenue cycle solutions.

*Easily manage audits from the Letter of Intent to Audit (LOI) through adjudication

*Track all aspects of audit stages from pending to closed and every stage in between

*Synchronizes seamlessly with Outlook HIPAA-HITECH Compliant Cloud Based Rich reporting ability

*Tracks error rates by department or even by single line item

*Track RAC and other government compliance audits including attaching the entire medical record

*Create clinical appeal letters and track their denial “root cause”

*Create and defend DRG/APC claims

*Defend (all types) of coding denials

*Comes with built in business logic, and rich reporting for granular interpretation delivered monthly

*Virtual 24/7 Case Management Third Party Appeals Tablet/Smart Phone Compatible Dramatically reduces audit workflow time

*Built by auditors for auditors

*Possible to suggest and add new features based on your needs

*Simplified audit scheduling with automated process flow and opposing auditor invite and updates