At Synthesis HealthSoft, we deliver a robust, scalable, and compliant claims management ecosystem designed to handle the complexity of modern healthcare payers. Our platform combines advanced adjudication, intelligent re-pricing, and real-time validation to ensure every claim is processed with accuracy, speed, and compliance.
We process millions of transactions each year through a secure and proven platform — with deep expertise in state and county-level US regulations, ensuring full compliance and precise charge control across all specialties.
From intake to payment and post-payment audit — we support every stage of the claims lifecycle with precision and speed.
Our adjudication engine embeds critical validations at every stage, going far beyond standard processing.
A powerful multi-layer rules engine combining Medicare standards, plan-specific configurations, and user-defined edits for maximum accuracy.
Real-time eligibility checks at the point of claim intake, ensuring only valid claims proceed to adjudication.
Automated contract validation and pricing accuracy checks against current fee schedules and network agreements.
Hundreds of automated checks — eligibility, authorization, duplicates, TFL, and plan-specific rules running simultaneously.
Millions of transactions flow through our platform annually — built for enterprise-level payer operations with unmatched reliability.
Built-in workflow automation across all modules ensures seamless integration and operational efficiency at every step.
Stay informed with actionable insights via our comprehensive reporting module designed for decision-ready analytics.
Choose the delivery framework that best fits your organization’s size, complexity, and operational goals.
Expert claims specialists embedded into your operations — managing adjudication, appeals, and reporting using your existing systems.
Our Synthcare claims platform deployed as a service — delivering automation, real-time validation, and full reporting capabilities.
Our platform combined with dedicated claims specialists — a fully managed, high-performance claims operation built to scale.
The expertise and infrastructure that sets us apart in claims management
Partner with Synthesis HealthSoft to achieve higher accuracy, faster payments, and complete compliance in your claims lifecycle.