HealthClaims

Ready for end-to-end automation of your claims processing operation, with advanced auto-adjudication and customer-configurable workflow?

For multiemployer benefits administrators challenged by the ever-changing regulatory landscape, complex health plan design, data security, and the drive to improve efficiency, Bridgeway presents HealthClaimsXG,  Taft-Hartley’s most powerful, versatile claims administration system.

A complete solution for today’s health benefits administrators, HealthClaimsXG supports the management of self-insured, PPO, HMO and Medicare Supplement plans, as well as Dental, Vision and Disability claims, and provides optimal auto-adjudication that YOU control based on your organization’s needs. HealthClaimsXG is fully compliant with HIPAA 5010 and ICD-10, and seamlessly enables smooth processing of secure EDI files with trading partners.

basys Health & WelfareAdvanced Navigation Tools

The modern HealthClaimsXG interface helps operators quickly navigate to the screens they need to process each claim, increasing payment accuracy and reducing costly human errors. Bridgeway’s Claims Navigator immediately identifies processing issues for the operator to resolve, while data-rich demographic screens put supporting member and provider info and related correspondence and images quickly at hand. With one click, operators can pop open a detailed Claim Snapshot screen to review patient, provider and plan specifics to speed claim processing. 

Boost Auto-Adjudication

Bridgeway customers routinely achieve the industry’s best first-pass rates thanks to our advanced Auto Adjudication Engine, which lets you process high volumes of claims without manual intervention. And HealthClaimsXG is built on the industry’s most secure and advanced technology platform, with built-in HIPAA safeguards and encryption for data at rest and in transit.

Why HealthClaimsXG?

  • Rules-based auto-adjudication reduces processing backlog

  • Integrated workflow engine

  • Separate Professional (CMS1500), Institutional (UB04) and Dental (AMA) claims screens

  • Administer HRA, HSA and FSA plans

  • 23 Coordination of Benefits methods to suit any plan design

  • Illness and Admissions tracking

  • Referral and Authorization tracking

  • Industry-standard pricing options like UCR, RVU and others

  • Integrates with Fraud, Waste & Abuse detection partners

  • Integrated imaging for paper claims, correspondence, etc.

  • Fully supports HIPAA 5010 and ICD-10

  • CORE Phase 3 compliant for EFT/ERA