SentryHealth Launches Claims Adjudication Automation for Third Party Administrators

SentryHealth, a leader in care navigation, announced a full-scale launch of a configurable, automated claims adjudication interface for Third Party Administrators (TPAs) that drives greater efficiency and accuracy.

With the interface in place, TPAs can easily and automatically identify, process, and pay claims related to SentryHealth referrals as well as determine when to apply a discount or incentive based on the plan design. In addition, TPAs benefit from a real-time feedback loop that enables them to communicate with SentryHealth regarding problematic claims for a quick resolution.

The interface greatly reduces the administrative time involved in manual claims adjudication, improves claims processing efficiency, and drives greater accuracy. It is configurable and scalable based on TPA and client needs.

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“Through this automation, we are proving to be a partner in tech innovation to our TPA clients,” remarked Kevin Porter, SentryHealth CEO. “Our goal is to deliver value through greater efficiencies and cost savings and this is one of many steps we’re taking to do so.”

SentryHealth is a clinical-first care navigation company that combines data science, technology, and an experienced care team to match members with the best available health care. It blends expert guidance with personalized care plans, empowering members to make more informed decisions while connecting them to high-quality, low-cost care. From virtual health coaching to locating high-quality providers to managing complex medical conditions and prescription drugs, the company drives smarter utilization of benefits, better outcomes, and real cost savings.

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