Claim adjudication services to optimize provider payments and boost member satisfaction
PCH Health's claims adjudication solution is designed to revolutionize how payers manage claims processing.
Leveraging over 30 years of industry expertise, our experts ensure accurate and timely determination of benefits, provider payments, member liabilities, and plan responsibilities.
Automated processing
Automated tools streamline processing, including coding, data entry, decision-making based on predefined algorithms and rules.
Integration with data sources
Easy integration with multiple data sources, such as provider contracts, regulatory information, patient records, and policy details, for accurate claim assessments.
Fraud detection
Advanced fraud detection algorithms spot suspicious behaviors and patterns to prevent financial repercussions.
Transparency and efficiency
Automated claims adjudication processes foster trust among policyholders and providers, enhancing process efficiency.
Why PCH Health?
With decades of expertise and a commitment to innovation, PCH Health ensures precision and reliability in every adjudication decision.
Our tailored claims adjudication services are designed to meet payers' specific needs, enhancing member satisfaction, efficiency, and cost savings.
Our delivery capabilities and performance benchmarks
PCH Health's claims adjudication services streamline payment through meticulous assessment and resolution
193M+
Lives supported
30%
Reduction in pended claims
100%
HIPAA Compliant
Why opt for PCH Health’s claims adjudication solution?
- HIPAA-compliant organization
- Highly trained staff
- Transparency and efficiency
- Payment accuracy
- Provider engagement
- Fraud detection
Awards and Certifications
