User:Adaptis

adaptisinc.com

Adaptis

Welcome to the Adaptis AboutUs page. We are exclusively committed to our health payer clients. Adaptis' integrated services include business process outsourcing (BPO), medical management, account management and consulting. Tēla Sourcing, an Adaptis company, complements our offering with blended-shore services.

About Adaptis

Adaptis has provided Business Process Outsourcing (BPO) services to health payer organizations since 1996. Our executive management team is a professional powerhouse of health care business, operational and technological talent. Inherent in our business philosophy is customer intimacy, the methodology that embraces collaboration, service, and adaptability.

Services

Our complete, integrated solution offering includes comprehensive claims management (paper to payment) and value-add services through our Strategic Partners, all backed by contractually binding Service Level Agreements. Comprehensive Adaptis services enable you to focus on member care, provider support, and compliance with government and other regulatory bodies. We support you in a variety of functions, such as:

• Health payer claims management,which includes comprehensive claims processing: electronic data interchange (EDI), adjudication and
  reprocessing, claims pricing and rules maintenance, member eligibility of benefits (EOB) reviews, benefits coordination, and claims reporting. Additionally, our blended-shore options give you more choices on delivery methods.

• Membership: enrollment, updates, rosters, reports and call center

• Provider: database and directory maintenance, web-enabled features (claims, eligibility, referral status) and call center
• Medical Management: Utilization Management, 24x365 Nurse HelpLine, Case Management, Disease Management, Claims Cost Management(Pdf),
  24 hour referral, Credentialing, Pharmacy Benefits Management, Health Risk Assessments and HEDIS reporting assistance

• Consulting: Business Process mapping ("As Is" and "To Be"), Change Management, Project Management through our corporate Project
  Management Office, Crisis Management (claims backlog reduction and similar projects), and Health Care Compliance Auditing and Training

• Financial: fund pool set-up, capitation, fee-for-service checks and processing, remittance advice

• Business Intelligence and reporting: utilization reporting and analysis, ad hoc query and reporting services
• Offshore: manual data entry, front-end claims pre-adjudication

Adaptis’ Account Management underlies our suite of services. It ensures our customer relationships and our business framework, processes and practices are always on track to consistently meet our contractual service level agreements.

Contact Us

If you have questions regarding either our business process outsourcing or consulting services, please contact us at .

To apply for or inquire about open job positions, please contact us at .

Adaptis Mailing Address

Adaptis
999 Third Avenue, Suite 1700
Seattle, WA 98104
Our Telephone Number

Phone: 206.749.9456
Fax: 206.971.7205