Revolutionize your claims processing with our advanced services
PCH Health leverages advanced analytics and automation to optimize claims processing and submission for healthcare payers.
With over 30 years of expertise, our experts excel at reducing pending claims by over 30%, claims redetermination requests by 21%, and clinical edit exceptions by 24%.
Automated appeals & denials management
Automatically reassociate original claims with submitted appeals, providing real-time status updates.
Continuous system enhancement
Leverage Iterative Feedback Loop Technology and Predictive Analytics to evolve and improve the system in response to changing rules and regulations.
Fewer errors, cleaner claims
Our advanced editing platform uses Pre-clean claims to reduce errors and expedite exception processing.
Superior visibility and insights
Clear audit trails, compliance, and automatic transaction tracking facilitate effective communication and optimized workflows.
Why PCH Health?
PCH Health excels at handling complex claims for healthcare plans, delivering proven results, and building trusted partnerships. Our robust infrastructure ensures top-notch data security and compliance, supporting over 193 million lives to date.
By integrating AI, machine learning, deep learning, and natural language processing into our operations, we effectively manage error-prone manual tasks and proactively mitigate issues before they arise.
Ready to streamline your claims processing?
Our delivery capabilities and performance benchmarks
PCH Health’s claims processing services increase accuracy, expedite reimbursements, and improve cash flow.
>30%
Reduction in pended claims
21%
Decline in claims redetermination requests
24%
Decline in clinical edit exceptions
193M+
Lives supported
Seamless Integration & Scalability of Claims Processing Services
At PCH Health, our claims processing services are designed for seamless integration with your existing systems, minimizing disruption and accelerating time-to-value. Whether you’re managing a small regional plan or a large national network, our scalable solutions grow with your needs, adapting effortlessly to regulatory changes, evolving payer requirements, and increased claim volumes.
Our flexible deployment models ensure that healthcare payers can harness the power of automation, AI, and real-time insights without costly overhauls or complex migrations. With PCH Health, future-proof your claims operations while maintaining the highest standards of accuracy, compliance, and performance.
Why choose PCH Health as your best bet for claims processing?
- HiTrust-certified infrastructure
- HIPAA compliant organization
- Real-time insights and transparency
- Customer-centric solutions
- Comprehensive audit trails
Awards and Certifications
