For MCOs & payers
A benefit that holds up to review.
Every trip runs on a credential-gated network, and every claim clears the same checks, so the transportation benefit stands up to scrutiny.
Credential-gated network
Only current credentials get on the road.
The network checks itself before a trip is ever assigned.
- Drivers and vehicles with lapsed credentials are blocked from assignment, checked live at dispatch.
- Providers only receive the service levels they’re formally approved for, enforced at the database level.
- Every assignment carries the credentials it was cleared against.
Claims discipline
The same checks on every claim, every time.
No claim skips a step, and nothing changes after it’s frozen.
- Four automated scrubbing checks before submission.
- Seven adjudication checks route every claim to approve, review, or deny.
- Thirteen fields frozen at submission into a tamper-evident record.
- A database constraint makes double-paying a claim impossible.
Program integrity
Exceptions surface before the money moves.
Flagged claims wait for a person; the rest keep moving.
- Flagged claims are held out of auto-payment for exception review.
- Pattern reports and CSV / Excel exports for your own analysis.
- Timely-filing windows warn before they lapse.
Exception reviewSample data
CLM-4471Timely-filing: 5 days left
Held out of auto-payment · flagged for review
CLM-44707/7 checks · auto-approved
Pattern report · export CSV / Excel