Auto-Reimbursement
Why Automate?
TPAs have high labor costs associated with manual processing for FSA/HRA claims. Relying on patients to submit claims significantly slow down adjudication and is subject to errors or insufficient information. Therefore, TPAs are looking for cheaper and more efficient alternatives.
What is Claims XO®?
Claims XO® streamlines and simplifies the request-for-reimbursement process. Claims XO® is a “claims clearinghouse” that scrubs electronic claims for errors, validates and filters them before generating TPA specific import files that you can directly import into your system (WEX Health, Alegeus, home-grown, etc.).
Why CXC?
Today, CXC works with over 75 different insurance carrier feeds for processing medical, vision, dental, etc. claims. We handle all future format changes and store all claims in a secure SOC2-compliant system. Our unique ability to store and reprocess claims ensure you get the maximum benefit from your claims feeds.
The Benefits
Carrier Formats
Capability to handle any electronic format provided by the insurance carrier
Claims Aggregation
Ability to aggregate original, reversals (negative claims) and adjustments
Custom Rules
Configurable rules engine to apply TPA specific rules like copay discounts
Claims Import
Consolidation of all claims into one TPA-specific format (e.g. Alegeus, WEX Health, etc.)
SOC2 Compliant
Secure data transfer and archival of insurance claims data for up to seven years
Customer Service
Web portal and reports for audit notifications, error alerts and filtered claims
“CXC has enabled us to rapidly add new claims feeds from major US health insurance carriers. Our plan participants enjoy automated claims filing and fast settlement. Our operations team enjoys increased productivity as electronic claims stream seamlessly into our processing systems without the hassle of hand keying or scanning”
--EVP, Business Technology Services, "Top 5" TPA
