CLAIMPOINTE

claimpointe for medical stop loss

claimpointe is a claim reporting warehouse for medical stop loss reporting - a central reporting database that manages group funding requests and reporting, and proactively identifies stop loss filing requirements and communicates them timely so that you never risk claim denials or reimbursement reductions. CRW is the essential tool for stop-loss communications and keeps everyone in the loop.

Claim Interface
  • Eligibility / Enrollment
  • Claim Adjudication
  • PBM Feeds

CRW
Management / Referral / Renewal
  • Claimant Summary by Policy Year
  • Top Diagnoses
  • Trigger Diagnoses
  • Disclosure
  • Claim Details by claimant and benefit type
Stop-Loss Carrier Reporting
  • 50% Notification
  • Trigger Diagnosis Notification
  • Specific claims
  • Monthly Aggregate Reports
Group / Broker Reporting
  • Aggregate paid claims tracking reports
  • Funding Summary
  • Check Registers that can be sorted, printed, exported to Excel, break out by Division, Location

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