Claims adjudication

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Advanced technology, innovative claims management, administrative services, and fully branded services to help you build flexible custom solutions for your business.

Two people sharing a desktop computer to browse the GreenShield services available to them
A person making a GreenShield claim while using their laptop at home

Claims management solutions

Advantage is our automated, flexible, patient-centric, and rules-based health benefits management system that provides integrated claims adjudication and administration customized to your needs.

  • Rules-based system
  • Fully scalable system architecture –capacity on demand
  • Accurate real-time claims adjudication

Customized client experience

Put your brand front and center with solutions designed to feature your organization across services and tools, ensuring your clients connect directly with your organization, not ours

  • Complete suite of claim services and functionalities
  • Fully-branded solutions
  • User-centric platform
A pair of people using a laptop together while smiling
A man and a woman working together at a computer in a modern office environment. The man is standing and leaning over the desk, while the woman is seated and looking at the computer screen. Other people are working at desks in the background.

Fraud & abuse management solutions

Stay a step ahead of benefits fraud. Designed with advanced prevention and detection tools and backed by intelligence-led experts, Claim Watch is dedicated to combating fraud, ensuring the integrity and sustainability of your plans and protecting the health of your members.

  • Outsourced program
  • Technology and consultation services
  • Structure inspired by law enforcement expertise

Contact centre solutions

The calladvantage platform makes it easy for call centre agents to drive first-call resolution and deliver superior support for your customers.

  • Quick and efficient without compromising service
  • Focused on first-call resolution
  • Shows information at the speed of conversation
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Learn more about our claims adjudication solutions

Contact us for additional information regarding our products and services.
We would be happy to hear from you.