Pillar 03 of 05 · Process2PointIA

Every Claim, Priced Right. Every Overpayment, Recovered.

P2P Claims & Payment keeps every claim, fee schedule, and drug code accurate from intake to reimbursement — and automatically finds and fixes what was paid wrong, without ever touching the original record.

ClaimOps
Bulk claim status updates and denial processing.
RateLogic
Automated fee schedule generation and rate imports.
NDC IntelliSync
Drug code updates and pricing validation.
Recover
Automated repricing and reversal of paid claims.
Batch Queue
Excel / CSV
Updated
Update Status
Deny Claims
P2P Claims & Payment · ClaimOps

Update Thousands of Claims. One Batch at a Time.

A focused tool for bulk claims management — enabling mass claim status updates and claim denial processing via input files. Designed for efficient, auditable batch operations on large claim volumes.

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P2P Claims & Payment · RateLogic & NDC IntelliSync

Rates and Drug Codes That Stay Current, Automatically.

RateLogic

Fee Schedules That Keep Themselves Current.

A powerful utility for generating healthcare fee schedule inload files. Automates rate imports and produces files compatible with your healthcare management system — reducing manual effort and ensuring accuracy.

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NDC IntelliSync

Drug Codes That Are Always Accurate.

Automates the update, validation, and maintenance of National Drug Codes, keeping drug pricing and claims processing accurate across every health plan you manage.

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P2P Claims & Payment · Recover

Reprice Paid Claims Automatically. Without Touching the Original.

The RRE (Reverse & Recovery Engine) finds eligible paid claims, copies them, reprices the copy under current contract logic, and releases it to Accounts Payable — reversing the original only when the financial outcome actually changes.

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Sample Paid Claim
Eligible for Review
Eligibility Check
Create a Linked Copy
Reprice Copied Claim
Release to Accounts Payable
Original Claim Reversed
Scanning for eligible paid claims…
Let's Work Together

See What Accurate Claims
& Payment Looks Like.

Let's talk about where claims, rates, and drug codes are still slipping through manually — and how P2P Claims & Payment can close the gap.

OptiVera Solutions

Empowering healthcare and technology-driven organizations to achieve operational excellence through intelligent automation, advanced technology platforms, and strategic communications.

PO Box 1052
Riverview, FL 33568
United States
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