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Silicon Peak created a customizable system designed
specifically for processing health care claims in real-time.
The system has a Rule Development Environment to accommodate
claim processing rules that change on a daily basis as well
as a Rule Engine that applies those rules to claims. The system's
development was funded by Physicians Consultant and Management
Corporation and drives that company's claim processes, providing
unprecedented speed, unlimited flexibility and control that
previously did not exist.
About Physicians Consultant and Management Corporation
Physicians Consultant and Management
Corporation can provide a fully integrated managed care approach
to claims administration. Their claims system has been customized
to meet the needs of MCOs ensuring the accuracy and reliability
their customers expect by supporting a wide range of payment
methodologies and claim processes. Global capitation, Fee
For Service, carve-outs, variable and non-deficit capitation,
incentive and risk pools, case rates and multiple risk and
incentive corridors are a sampling of the payment methodologies
that our system supports. In addition, they can offer EDI
processing and a variety of complex provider network arrangements
such as case rates, per diems, budget fund models and tiered
per diems.
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