Coalition America Inc. (CAI), a provider in medical claim savings, and WLT Software of Florida, an international provider in providing software for employee benefits, managed care, workers’ compensation, and claims editing, announced a new integrated product called “The EDI Connector.”
“The EDI Connector” is a solution that enables direct electronic communication from the Benefit Administrator (such as a TPA) to CAI. Specifically, the TPA can now use their WLT system to pull eligible in-network and out-of-network claims and transmit them via EDI directly to CAI for repricing. The bills are returned electronically to the client for auto-adjudication. The process will also provide key edits to the claims prior to sending to CAI reportedly resulting in improved workflow and a reduction in costs associated with “ineligible” claims.
“The EDI Connector enables a simple, effective transfer of claim and repricing data between WLT users and Coalition America,” stated Tom Brooks, president of WLT Software of Florida. “With this new integrated capability we now offer our customers the ability to effectively re-price and communicate this niche segment.”
“We have several clients currently using the WLT Software adjudication platform. This new relationship and state-of-the-art connectivity will enable us to significantly improve the repricing and adjudication process for payors by eliminating many of the current manual processes involved with sending claims for repricing, while also allowing them to discount more claims faster,” added Scott Smith, president, Coalition America Inc.
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