Adjudication and Claims Management Solutions

Claims processing for TPAs and TPPs

Adjudication & claims management made simple with AdjudiCare

Benefit from an effective and cost-efficient adjudication and claims payment product. With AdjudiCare you can:

Help identify fraud

Our patented Optical Character Recognition (OCR) technology flags suspicious healthcare claims for review.

Customize AdjudiCare to suit your needs

No matter how many plan designs, funding arrangements or organizations you work with, our claims processing software can handle your adjudication process.

Offer your clients proven claims management

Streamline the adjudication process and make electronic claims processing and payment more efficient with our health and dental claims software.

Learn more about Adjudicare

Manage, adjudicate and pay out claims, quickly and simply

Streamline the adjudication process for electronic drug, dental and extended healthcare claims while building your brand. AdjudiCare ensures that claims are adjudicated and paid quickly, allowing flexibility and transparent disclosure on the benefit plan,

Here’s what AdjudiCare can do for you

Streamline claims processing

With AdjudiCare, plan members can submit electronic claims through our intuitive mobile app or web portal, and healthcare providers can submit claims on behalf of their patients. Our rules-based engine allows for claims to be adjudicated and paid in real-time*.

Provide clients with customized service

Access plan and sponsor members details, including current coverage with one click. Compile reports to easily analyze claims history and provide clients with tailored advice and efficient service.

Accommodate multiple plan designs

AdjudiCare can adapt to different business needs, including various plan designs, funding arrangements or number of organizations you work with. It can be adjusted for coverage of First Nations and Inuit plan members, Health Care Spending Accounts and more.