Who we serve · MSOs, TPAs and QuickCap Users
Get more out of your platform and your people.
Real-world payer experience with QuickCap, paired with healthcare-trained teams that run claims, capitation, credentialing and care workflows for MSOs, TPAs, IPAs and managed care organizations.
Built for MSOs and TPAs
Common pressures
Sound familiar?
Administrators carry the operational load for many providers and plans at once.
QuickCap operations
Unlock the full potential of QuickCap.
Expertise in the payer workflows QuickCap was built for.
Claims Adjudication and Editing
Automated, streamlined claims processing in QuickCap.
- Adjudication and editing
- End-to-end claims lifecycle
- EDI integration
Capitation Management
Accurate calculation and processing of capitation payments.
- Accurate capitation calculation
- Capitation payment processing
- Role-based access and permissions
Care Coordination and Referrals
QuickCap tools for referral management and coordination.
- Referral management
- Utilization and care workflows
- Automated clinical alerts
Population Health and Reporting
Data analysis and insight from your platform.
- Risk stratification
- Analytics and reporting
- Workflow automation
Administrative services
Teams that run the work.
Healthcare operations experts, claims analysts and IT professionals who know payer environments.
Claims Processing
Review, validation and adjudication aligned to payer guidelines.
- Payment determination and RA
- Denials and adjustments
- Turnaround and denial-rate tracking
Contracting and Credentialing
NCQA-compliant credentialing and contracting support.
- Primary source verification
- Committee support
- Ongoing monitoring
Member Data Management
Enrollment and eligibility processed on time.
- Enrollment processing
- Eligibility processing
- Ongoing data entry
Provider Relations
Engagement and training for your provider networks.
- Regular communication
- Regulatory and compliance training
- Business development
Clinical services
Clinical review when you need it.
Utilization and care management teams that work inside the same workflows.
Utilization Management
Evidence-based review against your medical criteria.
- UM intake and prior authorization
- Concurrent review
- Discharge planning
Care Management
Coordination that keeps high case volumes consistent.
- Medical necessity evaluation
- Appointment and transport coordination
- Appeals and grievances support
Results
Proven in payer environments.
FAQ
Administrator questions, answered.
Have a question we did not cover? Add it to your support plan request above, or call us at (833) 335-6270.
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