Claims Management

Claim Processing Optimized for Your Lab

Claim processing designed to be as diverse as your lab’s reimbursement requirements. With expertise gained from more than 40 years of industry experience and billions of claims processed, Quadax engineered a claims management solution as dynamic as your needs. Balancing the complicated rigors of multitudes of unique payer requirements, dedicated Quadax claims professionals continually monitor published and unpublished payer payment requirements and denial logic so that they can amend complicated rules engines proprietary to Quadax. This unique and thorough feature, available only to Quadax clients, empowers users to identify and correct problems before they are submitted to payers. Shortened payment cycles = faster reimbursement. It’s that simple.

Claims to Cash Flow—Your Best Path

Automate your business rules and streamline your lab’s claim processing. Accounting for each payer’s unique requirements and policies, our solution identifies the best path for payment. The Quadax Claims Management solution works with you to get it right at the beginning—with the ability to apply client-specific business rules to support your dynamic business requirements prior to claim submission. From BlueCard routing, automated MUE (Medically Unlikely Edits) and CCI (Corrective Coding initiative) edits to available CPT bundling options and CPT replacement rules, our solution optimizes claim processing to deliver expected reimbursement.

Fast-Track Your Receivables

Turning receivables into reimbursement is our #1 goal. Quadax fast-tracks your cash flow by employing our proprietary clearinghouse with configurable automated workflow to ensure clean claim submissions. Our dedicated team of payer experts maintain a library of millions of claim processing rules resulting in an industry-leading 99.6% first pass rate with payers.

 Follow the Rules

Payer requirements and policies are regulated by standard insurance plans, contracted engagements, or government plans (Medicare LCD & NCD rules). It is important to know what a payer requires to start the claim on the best path for payment.

 Self-help Editing Solutions

Starting with the strength of our solution’s industry edits, you have the option to add additional rules and edits to create a tailored fit. When you need client-specific claim processing, client edits can easily be made by you and your staff.

Minimize Eligibility Denials


Using electronic eligibility requests, our solution alerts billing staff if information is missing or inconsistent prior to claim submission.

 Gain Full Visibility


Empower management decision making, identify areas for improvement, and track claims at every step with our Business Analytics, dashboard, and reporting tools.

Automate Workflow and Claim Follow-Up

Automated workflow, conditional claim correction, automated secondary/tertiary claim creation, and the ability to send more claims electronically makes the Quadax solution unique. Providing claim follow-up solutions that follow the money, you choose when to populate worklists, automatically send follow-up claims, or submit electronic claim status requests.

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