News & Events

SISCO Adjudication Protocol

Healthcare costs have continued to increase with little to no relief for members or health plans. Furthermore, many payers and carriers are linked to PPO networks, thus incentivizing them to pay as billed. Adding insult to injury, 1 in 11 claims contains billing errors!

At SISCO, we think it is important that you do not pay a penny more than you should. For that reason, we employ a team of tenured and educated claims examiners that manually adjudicate 75% of all claims paid. This manual intervention ensures a human being with human curiosity is viewing each claim to ensure the claim is appropriate and reasonable.  We believe this extra oversight into claims spend is well worth the 4 days of turnaround time to ensure we are protecting client assets.

In 2018, we saved our clients $50 MM (12% of savings) simply through our claims adjudication protocol. Can your payer offer you that savings?

For more information about how SISCO can help assist with claims cost, please contact Heather Harper at hharper@siscobenefits.com.