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Challenger is a real time, web-based analytical and workflow application that provides an unparalleled level of automation in processing/recovering claims that have been denied or rejected, or otherwise remain unpaid. Pre-adjudication processes monitor previously billed claims using payer specific claim-status technology (un-solicited or solicited) enabling organizations to start working on issues within a few days of claim submission. Customer specific knowledge rules automate steps that would otherwise require manual user intervention. Challenger routes tasks to the right place in the organization to be addressed, significantly reducing the time it takes for a user to follow-up on a claim or account. The automatic work distribution module continuously evaluates what needs to be prioritized and enables the staff to stay focused on the most critical tasks. A unified view of the entire account, including all associated claims and remittances, notes, appeals, and a history of all actions taken by users, helps to increase staff productivity. Appeal process management standardizes corrective actions. Specific exception alerts associated with each claim provide guidance on corrective actions minimizing the collector decision-making time. Performance reports empower organizations to manage the productivity of the staff based on payer-specific denial reasons and root cause. |
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