Claims Management
End-to-end management of the insurance claim lifecycle to maximize reimbursement rates.
Clean Claim Excellence
Our goal is "First-Pass Acceptance." Curenium's claims engine includes advanced scrubbing logic to catch errors before they are ever sent to the carrier.
The Claims Workflow
- Generation: Automated creation of claims from finalized clinical encounters.
- Scrubbing: Check for missing ICD-10 codes, invalid NPI numbers, or missing provider signatures.
- Submission: Secure EDI (Electronic Data Interchange) submission using standard HIPAA protocols.
- Reconciliation: Electronic Remittance Advice (ERA) is automatically applied to reconcile outstanding balances.
Scrubbing Error
Claim #CLM-9281 (John Doe)
"Missing primary diagnosis code (ICD-10) for outpatient surgical encounter."
Fix Now
Ignore
Denials Management
When a claim is denied, Curenium categorizes the denial reason and routes it to the appropriate staff member (Clinical vs. Administrative) for corrective action.
Smart Reconciliation
Automatically match bank deposits to claim batches to close the financial loop.
Audit Log
Detailed history of every claim change, submission attempt, and carrier response.
Configure our system to automatically submit batches of clean claims every 24 hours to maintain a steady revenue stream.