Partner with SamITHealth — transform payer operations
Talk to our payer experts about audits, pilots and managed services tailored to your needs.
Payer Solutions
Innovative, compliant & data‑driven payer operations
Empowering payers and TPAs with analytics, automation, and process maturity (CMMI-aligned) to improve claim accuracy, reduce denials, and accelerate reimbursements.
MAO & Risk Adjustment
Accurate HCC coding, risk score optimization and audit-ready workflows for Medicare Advantage and managed plans.
Claims Management & TPA Support
End-to-end claim lifecycle management, rule-based adjudication and third‑party administrator integration.
Medical Review & Repricing
Data-driven repricing, clinical review and provider engagement to contain costs and ensure fair pricing.
Workers' Comp & Auto Claims
Specialized workflows, compliance controls and adjudication tailored for workers' compensation and auto insurance.
Form Conversion & Interoperability
Automated CMS-1500/UB-04 conversion, EDI mapping and system harmonization for cleaner feeds.
Analytics & AI
Predictive analytics, denials root-cause and AI-assisted coding to continuously improve operations.