Mizzeto's claims processing platform leverages advanced automation to minimize manual errors and streamline the adjudication process for health plans and TPAs.
Our expertise spans major claims processing systems, including QNXT, Facets, Amisys, and QicLink. By optimizing these systems, Mizzeto delivers precise and swift claims handling, enhancing overall operational efficiency for our clients.
Mizzeto offers comprehensive member enrollment services for payers, utilizing Robotic Process Automation (RPA) to streamline and enhance the accuracy of the entire process.
From enrollment application submission and eligibility verification to plan selection, billing setup, and ongoing support, our expertise ensures seamless and efficient enrollment management.
Mizzeto's provider data management solutions harness advanced automation and data integration techniques to ensure the accuracy and completeness of provider information for health plans and TPAs.
Our expertise spans across leading provider data management systems, such as CAQH, Aperture, and HealthStream, allowing us to optimize these platforms for improved data integrity. By reducing manual intervention and eliminating data discrepancies, Mizzeto enhances provider network management, ensuring compliance, reducing administrative costs, and improving overall provider and member satisfaction.
Mizzeto's payment reconciliation process for payers uses automation to ensure that payments to healthcare providers accurately match submitted claims by calculating payments based on processed claims and identifying discrepancies between claimed and paid amounts.
Mizzeto's digital mailroom management services utilizes automation to streamline the handling and processing of incoming mail. By digitizing physical documents and converting paper-based information to Electronic Data Interchange (EDI), we ensure efficient sorting, categorization, and distribution of mail to the appropriate departments.
Our digital mailroom management also includes maintaining a secure digital archive of all documents, ensuring easy retrieval and compliance with regulatory requirements.
One of Mizzeto’s key services is providing advanced contact center support. We leverage state-of-the-art technology to automate routine inquiries, manage complex cases, and ensure that all payer interactions are handled with the utmost accuracy and professionalism.
Our contact center solutions are designed to enhance the member & provider experience by reducing wait times, increasing resolution rates, and providing 24/7 support.
Our Audit & Compliance services utilize advanced Robotic Process Automation (RPA) to meticulously review and verify claims, ensuring accuracy and compliance with regulatory standards. We identify discrepancies, prevent fraud, and streamline the audit process, saving time and reducing costs for healthcare payers.
Our compliance services are designed to help healthcare payers navigate the complex landscape of healthcare regulations. We offer continuous monitoring and reporting to ensure adherence to federal and state guidelines, mitigating the risk of penalties and legal issues.
Mizzeto’s reporting solutions utilize RPA to efficiently collect, analyze, and deliver data with exceptional accuracy.
We produce detailed reports that offer critical insights into various aspects such as operational efficiency, claims management, and financial performance, enabling healthcare payers to make data-driven decisions.
12414 James Madison Lane, Glenn Dale, MD 20769
