PCH Global – Claims Gateway

Exela holds third-party administrator licenses in numerous states in the US. This enables us to perform claims administration services in more locations, and better support the operations of our national partners, with comprehensive solutions that accommodate varying business needs across different regions.

The digitization of claims, records, payments, and correspondence improves the flow of information, removing friction and streamlining all processes. This direct communication link between payers, billers, customers, and data systems benefits all stakeholders.

PCH automatically identifies “Certain to Deny” claims, reducing manual claims processing and speeding up the process of comparing claims to the benefit or coverage requirements, while also eliminating problems of waste, fraud, and abuse.

Iterative feedback loop technology helps the system continuously learn and improve, using predictive analytics to identify errors in claims to enable proactive claims management and system flexibility as your contracts change.

PCH is much more than just a claims management and correspondence tool. It also improves Accounts Payable cycle times and payment integrity with overpayment identification functionality, and claims cross-checking and validation tools.

The system automatically tracks and records any addition, deletion, or modification to transactions, along with user reference and timestamps for all entries in the system, providing clear audit trails and ensuring full compliance. Digitized paper claims become visible to providers to limit processing and communication challenges.