Healthcare Claims Management

PokitDok's Healthcare Claims Management suite allows you to quickly and easily automate your claims processing so that you can increase clean claim rates, minimize revenue leakage, and drive down unproductive manual procedures. Our tools enable electronic submission, payment management, and real-time status checks on health insurance claims currently being processed.

The PokitDok Advantage

More Clean Claims with our Claims Management Suite

More Clean Claims

Experience clean claim bliss on a regular basis. Our Healthcare Claims Management suite makes it happen, with claims validation technology that flags problem areas before a submission is made.

Easy Electronic Claims Submission

Electronic Claims Submission

Submit claims electronically with PokitDok and liberate yourself from the endless loop of faxes, phone calls, and emails that overcomplicate healthcare invoicing.

Real-Time Status Check for Claims

Real-Time Status Check

See where things stand. Our real-time claims status check makes it easy. Send requests to one of our several hundred payer connections and receive a response in seconds.

Claims Payment Management

Claims Payment Management

With PokitDok, health insurance payer responses and ERAs are linked to the corresponding claim file. Just one of the nice touches that allows you to more easily monitor and manage accounts receivable.

PokitDok Network for Claims

PokitDok Network

Tap into an expansive network of over 700 health insurance payer connections that is continually updated. DokChain, our healthcare blockchain technology, can auto-adjudicate health insurance claims by implementing smart contracts, and accelerate reimbursements to providers. It can help payers too, by streamlining billing workflows and greatly reducing inefficient manual processes.

Easy and Flexible Integration for Claims

Easy and Flexible Integration

Our healthcare claims processing suite is refreshingly simple to onboard and operate, so you won’t experience disruption to your accounts receivable workflow. Plus you can choose from two convenient options: call our APIs directly from your web app, or use our pre-built application.

How It Works

Integrate electronic healthcare claims into your workflow with ease

How Claims Works - PokitDok Diagram

When a healthcare provider submits a medical claim to a payer for reimbursement using PokitDok’s Healthcare Claims Management suite, it activates an automated end-to-end process, from claim creation to adjudication tracking to reimbursement.

Claims Management App

Our claim entry tools allow you to create, validate, and submit healthcare claims electronically. You can integrate our APIs directly into existing websites or leverage our claims management web application. PokitDok's Healthcare Claims Management app combines our medical benefits verification and payment services into a single user interface that spans the claims processing workflow. The app enables real-time access to claims and payments through the following features:

Claims Management

Automatically populate claims data into dashboards & reports.

No need to manually re-enter data from other tools into PokitDok before submitting invoices. We make it easy to feed data programmatically using our Claims Drafts API.

Verify patient coverage at time of service.

Don’t wait in limbo for weeks, only to receive a denial due to inactive coverage. With PokitDok, you can verify health insurance coverage upfront and initiate payment recovery workflows sooner.

Catch mistakes before submitting claims.

Scrub errors prior to submission using our extensive rule sets.

Understand what claims need your attention.

It’s easy to prioritize your accounts receivable with PokitDok. We highlight the invoices that most require your attention, like recent denials, new payments, and pending registrations.

Claims Submission

Our Healthcare Claims API validates, translates, and securely submits medical billing data to our extensive payer network using a simple programmatic interface. It can also notify you when each claim has been received by a payer as it enters adjudication systems.

Claims Status

When medical claims enter the payer adjudication process, they often cross into a murky, opaque environment where payment status is almost impossible for submitting providers to gauge. This lack of transparency on payment status can cause major disruption to accounts receivable. That’s why we created our Healthcare Claims Status API to not only notify you when a payer receives a claim, but to also provide you with insight into where a claim stands within a payer adjudication cycle.

Claims Payments

Electronic Remittance Advice files are cumbersome to access and organize since they can include more than one claim. Which is why medical insurance clearinghouses have so much trouble accurately parsing and matching data from ERAs back to original claims. PokitDok’s Healthcare Claims Payment API solves this problem by providing real-time claims payment notifications, including full payment, denial, and ERA details.

See What Makes our Platform Special.

Grow with PokitDok

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Healthcare Claims suite product sheet

For more information on our Healthcare Claims Management solutions, download our latest product sheet

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At Doctor On Demand, we help employers reduce their healthcare costs while providing easy, digital access to some of the best doctors and other providers in the country. Employers and patients want to use Doctor On Demand's service through their insurance plan. PokitDok's suite of APIs allows us to check patient eligibility and then submit a claim for their visit directly to the insurance provider.

Adam Jackson, Co-founder, Doctor On Demand

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From startups to the enterprise, PokitDok scales with ease.

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