Web Based Repricing

Network | Reports | Sending Claims | Providers

HIPAA-compliant electronic solutions and real-time Internet access

Quest enhances our client’s abilities to better serve their client’s needs with our efficient web-based PPO claims repricing and processing system. With a state-of-the-art database and Web-based technology, Quest offers a comprehensive and user-friendly system for either single and / or double-entry claims repricing that can be done remotely from your claims department.

How it Works

If you have a patient claim that is out-of-network, Quest enables you to reprice a claim through our supplemental PPO which provides immediate results. Clean claims are repriced remotely from your location through our web-based PPO in our system and are returned repricied within seconds after submitting the claim. Complicated claims or claims that require physical Intervention by one of our associates may require more time for repricing.

Electronic Data Interchange (EDI)

For clients with a high volume of claims to be repriced, Quest can electronically connect with you to expedite the transmission of claims for remote repricing and then back for automated adjudication. TPA’s may use our web-based repricing system in combination with major claims adjudication systems such as RIMS and Erisco.

Using Quests efficient technology you automatically meet HIPAA standards and requirements. There will be no requirements for adjudication system upgrades or improvements to your existing systems! Our user friendly web site interface allows any claims department to process claims with ease and accuracy!

Verification of Provider Data

Quest uses highly developed proprietary software that enables it eliminate duplicates and miscoded providers.

Online claim tracking and reporting

Through this website your claims department can track the status of claims and run comprehensive savings reports.