A&G Healthcare Services Announces Post-Adjudication Workflow for TriZetto QicLink Payer Organization

A&G Healthcare Services, a national leader in technology based re-pricing and cost containment solutions, announced it will provide electronic re-pricing services for TriZetto Payer customers utilizing the QicLink system in a post-adjudication model. This new workflow allows for the seamless and automatic repricing of otherwise non-network claims achieving discounts of 20-30% utilizing the nationally known Amera-Net Travel Wrap network and personal negotiation.

Dallas, TX (PRWEB) June 22, 2005 -- A&G Healthcare Services, a national leader in technology based re-pricing and cost containment solutions, announced it will provide electronic re-pricing services for TriZetto Payer customers utilizing the QicLink system in a post-adjudication model. This new workflow allows for the seamless and automatic repricing of otherwise non-network claims achieving discounts of 20-30% utilizing the nationally known Amera-Net Travel Wrap network and personal negotiation.

The process includes a parameter-driven extract, automatically placing selected non-par claims on hold, while electronically sending these claims to A&G Healthcare Services for cost-containment consideration. On the electronic return to the Payer, the discounted claims are automatically updated, financial accumulators revised, and the on-hold claim status is removed for completion of the payment process. All this is done in a matter of hours for 60-80 percent of the submitted claims and three to five days for negotiated claims under the direction of the Payer client. All submitted claims can be tracked, reviewed, and reported on by Payer customers using A&Gs web-based IView system.

A&G Healthcare Services is pleased to offer installation, implementation, and training of the post-adjudication workflow at no cost to the QicLink Payer customer, and, depending on historical volume, is willing to pick up some or all transaction-based fees as well. From start of implementation to live EDI transmission can take as little as six (6) weeks to complete.

The environment for claims processing and claims re-pricing is changing dramatically, and payer organizations need the efficiencies produced by our many services and electronic claims re-pricing," said Norman Payson, chairman, founder and CEO of A&G Healthcare Services. Offering these services in a post-adjudication workflow environment, guarantees that all claims receive some consideration for discounting after all other cost-containment strategies have been exhausted," Mr. Payson added.

About A&G Healthcare Services
A&G Healthcare Services, headquartered in Plano, TX, is a medical cost containment company serving more than 400 Payer organizations by providing re-pricing and fee negotiation services for claims that have been determined to be out-of-area or network. A&G also owns and operates a national travel wrap PPO network named Amera-Net which provides superior coverage for payer clientele members. Amera-Net is a nationally recognized and accepted PPO travel wrap network with an established logo for ID cards insuring proper steerage to providers. A&Gs customers can take advantage of a shared savings program which can help pay for most or all of the front-end EDI costs. A&G has served the healthcare payer market for over eight years. For more information, please call Belinda Kelly at (972) 312-8589 Ext.108 or visit http://www.aghealth123.com.

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