Your expertise automated.
You are the hero when you use our purpose built Stop-Loss workflow system to track aggregate accomodation, run-in /run-out policies, aggregating specific and so much more. You don’t have to remember every little claims manual detail to be a Stop-Loss expert with Smart-LinQ.
Adjudication System Integration
We plumb to the source of truth for medical and claims data. Through our extensive partnerships, we get real-time claims data directly from the adjudication system of the TPA. You no longer need manual reports or spreadsheets to administer your Stop-Loss policies.
Claims Manual Automation
Gone are the days of storing claim and eligibility information on company-wide share drives. Our claim filing feature will automatically create the filings for you and start the work status process with no manual intervention. We automate the mundane and push claim filings to your work queue when the right conditions have been met.
Work Status Eligibility
Our carrier/MGU partners tell us that the number one reason a filing is rejected is because of some form of issue with eligibility. Maybe a date is missing or maybe some documentation. Our work status feature helps ensure you get it right the first time and get paid quickly.
Smart-LinQ provides a global view across your entire book of business in one single pane of glass. All data is rolled up from the member, to the employee, to the policy, to the group and finally to your organization as a whole. You can drill down to a member or up to your entire organization.