ClaimPoint

Enhancing Claim Submissions and Reimbursements for TPAs and Carriers

Claimpoint is a claim reporting warehouse for medical stop loss. A central database that automatically merges medical and Rx claims and proactively identifies stop loss filing requirements. Monitor claims against their stop loss policies, submit timely, and never risk claim denials or reimbursement reductions.

INTEGRATED SOLUTION

ClaimPoint Solution

Read below to understand ClaimPoint’s modules and their functionalities.

CLAIM INTERFACE

We ingest and map the following data:

Eligibility
Medical Claims
PBM Feeds

STOP LOSS NOTIFICATIONS AND FILING

We automate:

50% Notification
Trigger Diagnosis Notification
Specific Claim Reimbursement
Monthly Aggregate Reporting

MANAGEMENT / REFERRAL / RENEWAL

Claimant Summary by Policy Year
Top Diagnoses
Trigger Diagnoses
Disclosure
Claim Details by claimant and benefit type

GROUP / BROKER REPORTING

Aggregate paid claims tracking reports
Funding Summary
Check Registers that can be sorted, printed, exported to Excel, break out by Division, Location

Contact Us Today

Schedule a Demo

Our clients choose Connexure because our solutions are integrated, efficient and secure. We run on cloud-based software and secure our data through SOC II audits, penetration testing, and MFA.

Set up a demo today. We’ll deliver a comprehensive overview and show you why we are the leading option for stop loss medical insurance software in the country.