Setting the Standard
for High-Quality Medical Claims Resolution
Apex Resolve Claims ensures the delivery of consistent, high-quality medical claims reviews in full adherence to all regulatory and legal standards
About Apex Resolve Claims
Excellence and Efficiency
At Apex Resolve Claims we work diligently to maintain operational excellence and efficiency, ensuring timely turnaround of review submissions and responsive communication with all involved parties, in line with regulatory deadlines and service level expectations.
Experience
Recognized Authority in healthcare reimbursement, arbitration, and medical cost-containment. Over 40 years of experience in Employee Benefits, Claims Review & Reconciliation, Physician Relations, Medical Compliance, Medical Coding & Billing, Operations and Healthcare Management.
Industry Knowledge
Comply with all applicable federal and state laws, including the Affordable Care Act (ACA), Employee Retirement Income Security Act (ERISA), HIPAA, IIHI and state-specific external review statutes.
Efficiency
Consistently delivers expedited reviews within 72 hours and standard reviews within 30 days, ensuring quality and compliance on every case.
Unwavering Assurance, Backed by Proven Expertise
Apex Resolve Claims’ (ARC) mission is to deliver impartial, high-quality external medical reviews in compliance with legal and ethical standards.
- Ensure Impartiality and Fairness
- Promote Quality and Consistency in Claim Review
- Support Regulatory and Legal Compliance
- Safeguard Confidentiality and Privacy
- Maintain Operational Excellence and Responsiveness