About Datamethod
Our products and services enable health insurance organizations to achieve
significant and sustained claims process performance improvement. Health
insurers including Cigna Healthcare, Kaiser Permanente and Neighborhood
Health Plan have realized measurable claims process cost and service
improvement - all within the constraints of their existing platforms,
contracts, benefits, and processes. Our flagship solution, the Decision
Desktop, is a turnkey decision support tool designed specifically for
healthcare claims performance management. According to the Gartner Group,
the Decision Desktop "provides information to assess and improve process
automation." The claims for over 30 million members are managed using the
Decision Desktop.
Datamethod is a recognized industry leader in healthcare claims performance management.
We have led regional and national forums about claims process topics
such as provider management, auto-adjudication, and turnaround
compliance. States have consulted us on matters of compliance
legislation. Over 125 health plans subscribe to our periodical
The ClaimHeader,
which focuses on healthcare claims process management trends and best practices.
Datamethod knows claims
Our products and services begin and end with a business understanding of the claims process.
- We understand the complete lifecycle of a claim from date of
service to receipt date to check date.
- We have direct experience improving claim exception process
including, COB, duplicate claims, payment errors, denials,
paper claims, adjusted claims, claim authorizations and
claim attachments.
- Our tools support the daily production decisions claims managers face.
- We've seen first-hand the complexity of provider contracts, employer plans, and newer consumer driven plans.
- We know how claims systems and other platforms in the claims process work - and don't work.
Discover how, through technical expertise, relationship-building, and teamwork, Datamethod helps customers achieve results.