The Resolta workflow
Connect the information behind a claim to the requirement being checked and the response that follows.
Explore the process
Select a step to see what a useful claims review should establish. This example uses no customer data.
Identify the records used to prepare the claim, and make missing information visible before deciding what to do next.
The invoice is available. The applicable authorization still needs to be located in the approved system.
Record to keep: source references and open questions.
After submission
A response should tell you who sent it, which claim attempt it relates to and what it actually establishes. Payer acceptance, adjudication, remittance and cash receipt are different events.
Explore the claim-state guide →A few useful answers
Compare an additional review with the checks you already have. Useful findings, duplicate alerts, false alerts and missing information all belong in that comparison.
No. A scoped check addresses a particular requirement. Payer adjudication and payment depend on additional factors.
Email sales@resolta.ai with your payer and process. Confirm the supported route and an appropriate demonstration with the team. Do not send patient or claim details by email.
Start with your workflow
Build a short action plan, or talk to us about your payer and process.