Claims Processing

Our innovative solutions transform aging medical and pharmaceutical claims payment systems to provide flexibility for new payment options and programs.

With an integrated approach, we deliver efficient claims enrolment, adjudication and payments for both the public and providers.

At MAXIMUS, our comprehensive claims information system services include:

Systems:

  • System development, implementation and integration
  • Medigent® integrated COTS software product suite
  • Ongoing system maintenance and enhancement
  • Full requirements and test management services
  • Automated testing

Operations:

  • Managing the day-to-day operation of the claims system in production
  • Claims adjudication services
  • Weekly payments processing
  • Conformance testing services
  • Help desk services
  • Multi-channel contact centre operations
  • Document management operations
  • Program information