CGM CLAIMER ECP is a state-of-the-art IT-system that increases the efficiency of claim adjudication and decreases the claim amount for health payers. It enables health payers to administer their health claims online and in real-time by providing communication electronically through built-in web services between health payers and health care providers.
The software checks a detailed set of parameters such as policy conditions, contracted prices of healthcare providers, medical procedure lists and global medical rules diagnosis. It synchronously shares the data with health payers and healthcare providers to ensure claim authorization for outpatients and in-patients can take place within just seconds.
This electronic way of managing claim authorization is extremely time-efficient and cost-effective for both health payers and health care providers.