Comprehensive Claims Processing Services

Digitize your claims processing for streamlined workflows, automated decision-making, and centralized communications

1M+

Claim   
Processed   
Daily

30+

years of 
experience

400+

Plans  
Supported

24/7/365

support

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%.

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Automated appeals & denials management

Automated appeals & denials management

Automatically reassociate original claims with submitted appeals, providing real-time status updates.

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Continuous system enhancement

Continuous system enhancement

Leverage Iterative Feedback Loop Technology and Predictive Analytics to evolve and improve the system in response to changing rules and regulations.

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Fewer errors, cleaner claims

Fewer errors, cleaner claims

Our advanced editing platform uses Pre-clean claims to reduce errors and expedite exception processing.

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Superior visibility and insights

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?

Why PCH Health?

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

Why choose PCH Health as your best bet for claims processing?

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

Major Player
NelsonHall
PEAK Matrix Medical
Peak Matrix Healthcare

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