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From the hospital to the administrator, providing the required information for the administrator to assess the authorisation request.
Processed claim response
A claim response from the administrator to the hospital, once full claim processing has been completed, indicating what will and what won’t be paid.
From the administrator to the hospital, confirming what has been authorised or the reason for declining the authorisation.
Electronic claim sent to the administrator with up-front validation and confirmation of delivery responses back to the hospital staff more efficient.
Re-authorisation request and re-authorisation information
Same as above but catering for a re-authorisation event.
A claim that is sent to the administrator as soon as all claim billing information has been captured.
Upfront claim validation
An immediate claim response from the administrator to the hospital confirming claim receipt, and validating all claim data required for processing the claim.