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Software development efforts have been focused on the incorporation of artificial intelligence capabilities and workflow management tools in to the claims management systems in order to enable CorVel's unique process. In August 2010, CorVel introduced a provider look up app that can be accessed in the Apple Store and Google Play. This mobile ...
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Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4] The payor returns the claim back to the medical biller and the biller evaluates how much of the bill the patient owes, after insurance is taken out.
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CollaborateMD is a private company that provides cloud-based medical billing and practice management software services for independent medical practices and hospitals. [ 3 ] [ 4 ] The company's software uses real-time claim submission and built-in edits and integrates with various electronic health records (EHRs).
Catamaran Corporation (formerly SXC Health Solutions) is the former name of a company that now operates within UnitedHealth Group's OptumRX division (since July 2015). It sells pharmacy benefit management and medical record keeping services to businesses in the United States [3] and to a broad client portfolio, including health plans and employers. [4]