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 Integrations

Integration platforms for claims management are not created equal, so choosing a dynamic solution with a time-proven history and a roster of highly satisfied clients is paramount.

ClaimPilot has conducted more than 1,000 integrations during our history spanning 20+ years. We’ve successfully brought together various software subsystems to create a unified system for the Electronic Data Interchange (EDI) of:       

  • Workers’ Compensation in all 50 states. 
  • Medicare
  • Medical bill review
  • Pharmacy benefits
  • Benefits management
  • Brokers
  • Carriers
  • Banking payment features 
  • Conversions 
  • Fraud prevention analytics
  • Document management
  • Data bridges for accounting and reporting

Seamless integrations that don’t require significant customization typically involve a quick two-week testing phase on the front end, and an exceptionally low $100 monthly maintenance fee thereafter – perhaps the most high-value/low-cost “insurance policy” you will ever have that protects you from hourly fees for troubleshooting and resolution.

Carrier integrations automate and streamline the workflow, eliminate bottlenecks, enhance fraud detection and provide a uniform view of the end-to-end claims process. These integrations typically involve sending a tremendous amount of reserve data to the carrier, which then runs algorithms to pinpoint anomalies.

Custom integrations allow for tailored solutions that are comprehensive yet flexible.

Application Process Interface (API) integrations are simple and methodical. ClaimPilot provides all the documentation you need and a dynamic link library for plug-and-play software. With secure credentials, you can access our API through your browser and query a database for policy and claims data. You can also integrate with other companies’ APIs to retrieve specific data, such as policy information to enable adjusters to work with to-the-minute facts.

If you know your systems well and have an end goal of interacting with another system, whether internally or an external third party, our streamlined integration process involves three primary steps. First, a series of calls are conducted by our technical team with your technical team. Second, ClaimPilot develops specs and an estimate for making your workflow more efficient and or our business model easy to use with no upcharge for reports and integration. Third, the integration is quickly built out by our knowledgeable, experienced team.

If you need ClaimPilot to research and deeply analyze how the pieces must fit together to allow your system to share data with another system, the integration process has additional steps. But in the end, our objective remains the same: to provide a user-friendly platform that allows you to spend more time adjudicating claims and less time digging for data.

Elevated reporting capabilities are a direct result of certain custom integrations that bring new reporting requests. To the benefit of our extended ClaimPilot community, we share new reports with our client base at no additional cost.

If you’re looking to standardize how you manage claims, eliminate redundant tasks, maximize operational efficiencies, and have business functions that flourish, schedule a demo to see ClaimPilot’s first-of-its-kind platform and operations-enhancing features.