Manage Private Insurance Utilization and Reduce Fraud, Waste and Abuse

Softbir private insurance utilization software helps organizations reduce fraud, waste and abuse. The web-based solution integrates with more than 100 electronic health records (EHR) and electronic visit verification (EVV) apps to aggregate data across providers. As a result, organizations can check compliance with prior authorizations, verify compliance and analyze service delivery without time-consuming manual reporting.

Private insurance claims adjudication technology pre-screens, scrubs and provides all claims submissions in a standard format. The solution shows which claims match and which need additional information prior to payment. Data aggregation and near real-time processing provide commercial health plans with financial insights, as well as the ability to manage utilization of prior authorizations and improve outcomes.