Appeal Logic

Embedded within the ClaimLogic tools is the ability for clients to create customized work flow based on claims that either need to be appealed or require communications to go back to the payer. Our Appeals and Form Management solution allows our clients the ability to manage these submissions to the payer from one location. We will enable end users to select the form, auto-populate as much information as possible from claims and remittance advices on file and autopopulate default fields per user. Our system then confirms the destination for your forms and delivers all forms based on each payer's transmission requirements.

Every payer form is programmed to auto import remit and claim data

ClaimLogic hosts a library of client requested forms that can be imported into their work flow and immediately used. We also offer the ability to upload forms to be programmed and added to the library at anytime. Each form is programmed to allow auto-population of fields that exist within our system from your claims and remittance advice that will ensure both reliable data to the payer and greatly improve client efficiency in form creation and transmission to all payers.

Integrated and customized workflow for appeals, forms and electronic attachments

Once all the forms are loaded and programmed they will be available in the Appeals Work Flow. Since most appeals or claim follow-ups require a form that cannot be triggered by normal rules-based routing, we provide an input box that allows our clients to create a new Appeal or Attachment entry into the appropriate Work Flow.