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Transaction Director Service

Ingenix Transaction Director is designed to increase adjudication rates by performing payer-specific edits and rules that facilitate the delivery of clean claims to you. This process ultimately reduces rejections, costly human intervention, and resubmissions while enabling faster settlement with your providers.

With Ingenix Transaction Director, you receive only your claims for your members with all required information. 


Transaction Director Service overview

With its flexible and powerful rules engine, Ingenix Transaction Director Service helps you receive only your members’ claims so you can increase the rate of auto-adjudication, minimize multiple claim submissions, and achieve greater claim processing efficiency.

Value

• Increase adjudication rates on 100% paper and EDI data through the Ingenix Transaction Director “intelligent” gateway
• Eliminate duplicate claims, routing issues, and human intervention in the adjudication process
• Improve processes for requesting, obtaining, and receiving electronic claim attachments and COBs

Key features

  • Member eligibility verification
  • Automated provider selection
  • Duplicate claim checking
  • HIPAA validation
  • Standard editing
  • Customized editing
  • Reporting
  • Acknowledgements and rejections
  • Printing and mailing process
  • Exports/internal routing
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