Claim Processing

We provide automated claims benefit adjudication for healthcare payers. The application supports straight-through processing of claims, enabling healthcare payers to significantly increase auto-adjudication rates by offering a wide range of configuration rules such as.

  • Flexible benefits
  • Authorization validation
  • Duplicate claim (line) recongnition
  • Filling limit detection
  • Payment policies based on individual HCPCS/CPT
  • “Call out” rules that retrieve information from neighboring components

Clearing House

New generation Clearinghouse service for the processing of health transactions between Healthcare Providers and Insurance Companies. The transactions are processed in real time (real-time), achieving efficiencies and greater reliability in the data.


Data Analytics

We provide value-based care performance management analytic system and business intelligence tools that enable clients to.

  • Create custom made dashboards
  • Create flexible and customizable reports
  • Identify patterns in data to improve internal claim process
  • Prevent overpayments
  • Optimize risk-based contracts
  • Reduce medical loss ratios
  • Improve the cost and quality of the healthcare system


Our Data Centers count on all the security, redundancy, and contingency guarantees necessary for continuous processing, regardless any unforeseen events. 100% HIPAA Compliance.

Transaction Types

  • Eligibility (270-271)
  • Claims (X12-837)
  • Receipt Notifications (277 and others)
  • Claim Status
  • Payment Explanation (835)



9675 NW 117 Ave, Suite 115, Medley, FL 33178

Call Us

Miami: 786.708.8394
Puerto Rico: 787.361.5066


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