Netsmart private insurance utilization software helps organizations reduce fraud, waste and abuse. The web-based solution integrates with more than 100 electronic health records (EHR) and electronic visit verification (EVV) apps to aggregate data across providers. As a result, organizations can check compliance with prior authorizations, verify compliance and analyze service delivery without time-consuming manual reporting.
Private insurance claims adjudication technology pre-screens, scrubs and provides all claims submissions in a standard format. The solution shows which claims match and which need additional information prior to payment. Data aggregation and near real-time processing provide commercial health plans with financial insights, as well as the ability to manage utilization of prior authorizations and improve outcomes.
Manage Private Insurance Utilization and Reduce Fraud, Waste and Abuse
Simplify managing prior authorizations and claims submissions:
Simplify managing prior authorizations and claims submissions:Features