Horizontech drives higher auto-adjudication and first pass rates associated with conversion and edits on red and black paper and image-based claims, minimizing the cost and timeframes associated with claims administration and reimbursement. Passing an 837 file that is full of errors and issues is very costly to all parties, requires expensive post-submission review and delays reimbursement to providers.

We provide a single, flexible, configurable, rapidly deployed Platform as a Service (PaaS). Our PaaS enables ongoing solutions that fully automate mission critical business processes for paper and digital assets, including the criticality associated with the overall healthcare claims process.

Our Platform as a Service solves some very specific issues for healthcare claims processing:

  • Customizable for rapid, ongoing changes to adapt to any new processing requirements
  • Complete reconciliation and auditable, step-by-step
  • Single platform for receipt of all claims with dynamic routing control for offshore vs onshore data capture by state, as required
  • Ability to expedite batches through the platform for priority turnaround
  • Real-time queue status tracking of claims by process date, queue location in workflow
  • Customizable edits for each document type, by payer
  • Customizable invalid record output
  • Automated work queues for managing the adjudication process, resolving errors or anomalies
  • Automated routing of less legible data for internal review, prior to rejecting claim
  • Conversion of HCFA, UB and ADA paper and/or image-based claims to compliant 837 output