ReSolve™ Payor Solutions: Eliminating Costly Paper-Based Processes with Automated Capture, Conversion and Claim Adjudication

ReSolve™ Automating Claim Capture, Workflow and Validation

RCMS has the expertise to deliver the right Enterprise Content Management (ECM) & Workflow solution that provides staff with quick access to member and provider documentation, saving valuable time and administrative costs for the entire organization. The ECM platform, provided by Hyland’s OnBase, also offers secure health information exchange with providers as well as reporting and analytics. We can deliver ECM to your organization a SaaS based hosted solution or as an on-premise implementation.

From credentialing to claims processing and adjudication, RCMS automates workflow processes while improving data integrity and member services.

Our Payor solutions help staff to process and validate claims captured from standard forms, assisted by Robotics Process Automation and streamlined workflow processes. Some of these Payor specific solutions include Claims Processing (paper to 837 conversion), Appeals & Grievances and Provider Credentialing. For AP and other back-office applications, our Business Process Consulting services can help you to identify opportunities for automation and gains in efficiency with measurable ROI.

ReSolve™ Key Payor Solution Features

  • HL7, XML, CSV, X12 Interfaces
  • Enterprise Content Management (ECM)
  • Appeals & Grievances
  • Credentialing
  • Claims Processing
  • EDI Processing​
  • Paper to 837 Conversion
  • Data Validation
  • Member/Patient On-Boarding​
  • Provider Relations
  • Line of Business (LOB) Integrations
  • Robotic Process Automation (RPA)

Enterprise Content Management (ECM) for Payor Organizations

RCMS provides for hosted or on-site ECM for Healthcare Payors that provides staff with quick access to time-saving member and business information in a single data and document management repository.

Contact RCMS to learn more about all our Payor Solutions that can improve your member services and bottom line.