WLT's Certified Business Partner Program
WLT is setting the standards for quality on behalf of its Clients. As such, WLT has adopted strict guidelines for its Certified Business Partner Program.
Certified Business Partners have agreed to go through a rigorous process of development, testing and quality assurance. This ensures that WLT Clients will be able to easily utilize WLT's Certified Partner's products and services directly from their WLT applications.
Many companies have approached WLT, offering to integrate their product(s) with the WLT applications. After careful consideration and discussion, WLT has come to the conclusion that there are only a few companies willing to put forth the effort and resources required. WLT's goal is to provide its Clients with the best tools available to encourage and facilitate growth within our industry by helping our Clients increase revenue while reducing their costs.
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WLT is proud to welcome Coalition America, Inc. as its 1st Certified Business Partner.
WLT Software of Florida, Inc. and Coalition America, Inc. (CAI) announce 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 out-of-network claims and transmit them via EDI directly to CAI for repricing. The bills are efficiently and quickly returned electronically to the Client for auto-adjudication. The process also provides key edits of the claims prior to sending to CAI resulting in improved workflow and a reduction in costs associated with "ineligible" claims.
Who is CAI?Coalition America, Inc. (CAI) is the leader in medical claim savings, specializing in reducing the cost of in-network and out-of-network medical bills for group health and workers' compensation plans. We accomplish this by providing access to over 100 preferred provider organizations (PPOs) nationwide, negotiations services, and leading edge technology to streamline your repricing and adjudication processes. As a result, we saved our clients over $795 million since our inception in 1995.
HistoryCAI was founded in March 1995 in Atlanta, Georgia by Scott and Sean Smith. CAI was created to provide a unique solution to the healthcare cost-containment challenges faced by employers, insurers, payors, HMOs, re-insurers and MGUs. Today, Coalition America works with over 300 clients representing more than 12,000 businesses nationwide.
Mission StatementTo be the leader in healthcare cost containment and claims transaction efficiency.
Core Values- Creativity & Innovation
- Customer Sensitivity
- Job Expertise
- Perseverance
- Positive Attitude
- Team Work
- For our employees, "the best place ever worked!"
- For our customers, "unsurpassed customer service!"
- For our community, "investing in a better tomorrow!"
- For our industry, "lead the market!"
- For our shareholders, "continuous profitable growth!"
- Significantly reduced medical costs
- Streamlined repricing and adjudication processes
- Access to over 100 PPOs nationwide
- Increased profitability
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Adminisource
WLT is proud to welcome AdminiSource as a Certified Business Partner.
AdminiSource provides a fully integrated and comprehensive system to effectively address the challenges inherent in the healthcare payment and remittance distribution process. AdminiSource has become the largest independent healthcare payment and remittance advice distribution company in the country.
The knowledge and expertise of AdminiSource dates back to 1989 when its executive management were providing systems and output support services as an internal supplier to Fortune 500 insurance and health carriers. In 1992, this team began providing outsourcing services commercially to the healthcare, insurance and financial industries as an enterprise of Anthem.
After a number of successful years, a group of five executives who are still involved in the daily operation of the company today, purchased a block of business managed by Anthem's Dallas facility and relabeled it as AdminiSource in 1998.
AdminiSource is a privately held corporation located in Carrollton, Texas and has become the premier print and mail outsourcing vendor for the healthcare industry in areas of quality, price, and customer service. AdminiSource services clients nationwide and produces payments for over 6,000,000 claims per month, distributing more than 300,000 transactions per day.
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PHX
WLT is proud to welcome PHX as a Certified Business Partner.
PHX delivers advanced cost management solutions for health plans. The company combines claim processing automation with professional services to deliver a centralized approach to cost management, increasing savings in both the near and long term while dramatically reducing errors and turnaround time. The firm´s solutions are used by a number of the industry´s leading insurance companies, Health Maintenance Organizations (HMOs), and Third Party Administrators (TPAs). Services included in the PHX solution include bill review and audit, secondary repricing/claims negotiations, fraud and abuse detection, and health benefits trend analysis and reporting. All services are handled in-house for maximum privacy and legal and regulatory compliance. PHX also supplies full technology implementation, training and support for quick, seamless integration into any organization. Visit www.phx-online.com for more information.
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United Claim Solutions
WLT is proud to welcome United Claim Solutions as a Certified Business Partner.
United Claim Solutions (UCS) was established to assist insurance companies and healthcare payors in reducing the cost of in-network and out-of-network medical claims. All of UCS´s services are delivered with the attention to detail necessary to maximize medical claim discounts. Our team examines every claim to determine a path that will enhance savings while limiting any chances for reversals of the discounts that some experienced from other out-of-network repricing organizations. We have the flexibility to create and customize our services to meet your specific needs.
All of our services are delivered in a seamless and efficient manner either through MediWeb or through your WLT system. Any WLT or MediWeb user can choose UCS as their preferred vendor. Once this is done, a user can have their WLT system pull eligible claims and transmit them via EDI to UCS for repricing and/or bill negotiation.
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Bases Loaded
BLI is a service bureau company that cleanses and converts network provider, facility, and fee schedule data into our client's software specifications. BLI can perform a full provider cleanup from current data residing on your system and in turn manage your network data monthly. This is accomplished through cross-reference tables built per client network entity. BLI has a unique duplicate provider detection algorithm. This algorithm flags duplicate providers, which are immediately deleted and never forward on to our clients. We currently work with more than 320 networks monthly and have processed in excess of 200,000,000 demographics and billions of CPT codes since conception. Our newest, innovative service "Sure Hit" gives our client the cutting edge in auto-adjudication by guaranteeing a 98% provider hit ratio on all EDI claims. www.baseload.com
Other WLT Partners
A&G Healthcare
A&G Healthcare Services is an industry leader in the provision of cost effective claims management services. We are part of one of the largest medical networks in the U.S. with access to 100,000 hospitals and clinics, and more than 1-million healthcare providers. We specialize in out-of-area/network repricing through medical bill reviews, negotiated discounts, and medical audits to achieve the ultimate goal – savings on medical claims. www.aghealth123.com
Context 4 Healthcare
EMC Captiva´s Healthcare Reimbursement and Coding Suite of Products are now a part of Context 4 Healthcare, Inc. These products include CodeLink®, ClaimsEditor®, FirstPass™, RACAuditor™, UCR Fee Database products and the Knowledge Product healthcare databases.
Our UCR (Usual, Customary and Reasonable) Fee databases (Medical, Dental, Anesthesia, HCPCS, Outpatient Facility) and RBRVS data fit seamlessly into your WLT Software. www.context4healthcare.com
DenteMax
Provides a national dental PPO. www.dentemax.com
Eagle Business Solutions, LLC
Provides service for the Oracle database and supplemental Oracle consulting and support services. www.eaglebusinesssolutions.com
Enhanced Services International
Provides professional business process outsourcing including: Customer Service, Quality Control, Verifications, Order Fulfillment, Technical customer Support, Back Office Processes, Collections, Sales orders and information. www.eservicesintl.com
Global Claim Resources
Provides Medical Claim Re-pricing, Fee Negotiation, Medical Bill Review and Audit, Primary Network Access, Secondary Network Access, Claim System Integration, Data Analysis. www.gcrinc.com
Health Care Insight
HealthCare Insight® provides health care payors with a comprehensive suite of clinically validated fraud and abuse surveillance services to maximize claims administration accuracy and minimize payment waste. www.hcinsight.com
Ingenix Health Intelligence
Ingenix's MDR Payment System is a powerful relational database of Relative and Actual Charge Data (RACD) that helps you manage your costs and payments for fee schedule development for out-of-network and non-negotiated services. www.ingenix.com
JMS and Associates, Inc.
JMS provides "Simple Solutions for Complex Problems" to the Health Care Payor Industry. Our solutions begin with receiving EDI and Paper Caims, Converting Paper to EDI, Claim Validation & Correction of Eligibility and Provider Data, Network Routing, Web Claim Viewer Systems, and Remote Adjudication Services. To find out more visit us at www.jmsassoc.com or call us at (248) 489-8888.
Moody Review
Moody Review is a national health care cost containment company specializing in group health and workers' compensation bill review. For more than 15 years, Moody Review has helped health care payors combat rising health care costs. Clients include third-party administrators, large and mid-sized insurers, Preferred Provider Organizations, self-insured companies, non-subscribers and other entities that pay claims. www.moodyreview.com
Planwatch
Provides risk analysis, disclosure reporting, health plan analysis, historical plan modeling and web based reports. www.proservehealth.com
Web MD Business Development (ABF)
Provides flexible, dependable, and cost-effective solutions for the handling, printing, and distributing of claims communication. www.emdeon.com
Contact WLT
WLT Software2410 Northside Drive, Clearwater, FL 33761 USA
Phone: (727) 442-9296
Toll Free: (877) 807-4730
Fax: (727) 443-4936 email us for more information