Claims adjudication costs $25-$180 per rework. Manual processing takes 20+ days. Upware automates it in hours.
Request a DemoThe Integration Wall
Core platforms like TriZetto Facets and NASCO are Systems of Record, not Systems of Action. They lack native APIs for real-time automation.
Manual Work Queues
High-value claims sit in manual pend queues — Coordination of Benefits, Provider Not Found — where experts spend 20-45 minutes per claim navigating disjointed portals.
Fragmented Verification
Staff spend 15-25 minutes per check toggling between carrier portals — Highmark, TriZetto, NASCO — to verify eligibility at the point of service.
Clinical System Overload
Doctors and nurses navigate 4-6+ systems simultaneously — Epic, Cerner, and more. Constant context switching impacts care quality.
Claims Adjudication
Target high-pend queues like Inter-Plan Teleprocessing. Move from weeks-long manual cycles to real-time resolution with 95%+ first-pass rate.
Eligibility Verification
Automate verification of benefits across carrier portals at the point of service. Eliminate 15-25 minutes of manual portal navigation per check.
Denial Prevention
Address the root cause of administrative waste by ensuring 100% data accuracy before claim submission. Reduce rework costs of $25-$180 per denied claim.
Clinical Workflow Optimization
Reduce friction for clinicians navigating EMRs like Epic and Cerner. Unify multi-system workflows into a single AI-powered interface.
See how Upware drives onshore quality at offshore economics — with 95%+ first-pass resolution rates.