Your End-to-End Solution At Eldorado, we continue to bring best-of-breed vendors to our customers. When a function of the claims processing business is outside our core competency, we identify, select and partner with the best third-party vendors to extend your product offering and improve your profitability. When used in tandem with our partners' technologies, Eldorado's product offering can help you achieve the highest auto-adjudication rates in the industry. 
| Technology | visit this site | | HP is a technology company that operates in more than 170 countries around the world. We explore how technology and services can help people and companies address their problems and challenges, and realize their possibilities, aspirations and dreams. We apply new thinking and ideas to create more simple, valuable and trusted experiences with technology, continuously improving the way our customers live and work. | 
| Repricing | visit this site | | AMPS is a cost containment and reduction services company for the entire healthcare payer community. AMPS provides medical bill review (MBR), fee negotiation, and claims repricing services on behalf of payers using a cadre of physician specialists and a proprietary network of over 61,000 medical providers, and robust HIPAA compliant technology. AMPS has developed unique technologies that allow them to quickly and seamlessly review the details of medical bills and supporting clinical records. They protect their clients' interests by leveling the playing field of knowledge on medical service delivery. AMPS mission is to assure that their clients are receiving "A dollar's worth of healthcare for every dollar spent." | 
| Claims Management | visit this site | | AFounded in 2000, TC³ Health, Inc. provides healthcare payers with a total claims management solution to validate payment integrity and maximize savings. Utilizing proprietary claims management technologies, TC³ electronically integrates claims transaction systems with external loss control programs. TC³’s integrated loss control model, the TC³ Funnel, enables payers to sequence multiple cost containment technologies through a single connectivity source, assuring payment integrity while reducing paid medical exposure by up to 3-6% annually. The TC³ Funnel includes the following components: Integrated Prepay and/or Postpay Fraud & Abuse Detection with Investigations, Clinical Coding Compliance and Duplicate Detection, AccessPlus Supplemental PPO Repricing Program, Cost-to-Charge Benchmarking and Fee Negotiations, Retrospective Discovery & Recovery Services, Web-Enabled Data Analytics and Decision Support. TC³ is headquartered in Costa Mesa, CA. For more information, visit TC³ Health on the web at www.tc3health.com. | 
| Claims Recovery Specialists | visit this site | | In today's dynamically changing health care landscape, the greatest challenges facing plan administrators are containing claim costs and managing profitability. Subrogation and other recovery vehicles are important tools to control the cost of your benefit plans. The Phia Group specializes in controlling costs by retrieving collectible claim dollars. We estimate that over 2% of annual claims paid are recoverable through an effective subrogation and reimbursement program. This represents substantial money that can be returned to your benefit plans. Our technology allows us to discover more cases with recovery potential while our experienced attorneys ensure that your recoveries are maximized in every case. This results in more money returning to your plans. | 
| Real-time Windows Based Ad-hoc Reports | visit this site | | Actuate Corporation is the leading provider of Information Delivery solutions for Global 2000 companies and packaged application software vendors. Actuate provides the leading platform for retrieving business information from corporate databases and delivering interactive Web pages and Excel spreadsheets to customers, partners and employees. Actuate content is seamlessly integrated into corporate Web sites and packaged applications and can be printed and used to exchange data with other applications. | 
| EDI Transactions | visit this site | | Emdeon Corporation provides services that help physicians, consumers, providers and health plans navigate the complexity of the healthcare system. Our products and services streamline administrative and clinical processes, promote efficiency and reduce costs by facilitating information exchange, communication and electronic transactions between healthcare participants. Emdeon Envoy is the leading provider of electronic data interchange services for healthcare providers and commercial health plans and is Eldorado’s preferred vendor in this area. | 
| U&C Fee Schedules & Claims Edits | visit this site | | MDR/PHCS Employers, group health insurers, managed care organizations and many other specialty service companies are relying on ways to manage their reimbursement risk - and establish equitable fees - while controlling administrative costs.The Medical UCR Module provides UCR guidelines for more than 95 percent of all current CPTTM-4 codes for surgery, evaluation and management, medicine, radiology and laboratory procedures. Claims Edit System (CES) Claims Edit System is an automated, clinically derived editing and repricing tool that automatically reviews claims for coding accuracy and appropriateness prior to a claim being paid. CES is seamlessly interfaced into the Eldorado system allowing payers to turn on and off the edits by client and type of edit. Edits can be set to automatically be changed by the system or be pended for further review. | 
| Claims Editing, Clinical Bill Review & Auditing, Secondary Network Re-pricing & OON Negotiation, Fraud & Abuse Detection | visit this site | | PHX delivers advanced cost management solutions for health plans. The company combines claim processing automation with professional services to deliver a centralized approach to cost management, increasing savings in both the near and long term while dramatically reducing errors and turnaround time. The firm's solutions are used by a number of the industry's leading insurance companies, Health Maintenance Organizations (HMOs), and Third Party Administrators (TPAs). Services included in the PHX offering include bill review and audit, secondary network re-pricing/claims negotiations, claims editing, fraud and abuse detection, and health benefits trend analysis and reporting. All services are handled in-house for maximum privacy and legal and regulatory compliance. PHX also supplies full technology implementation, training and support for quick, seamless integration into any organization. Visit www.phx-online.com. for more information. PHX is the leader in cost management. | 
| Subrogation Solutions | visit this site | | SOCRATES, INC. is the only healthcare claims recovery firm that provides outsourcing services and software programs to health payors so that they achieve recovery rates that exceed industry norms with unparalleled case management from the Eldorado claims processing platform. The MY SOCRATES© software was developed by legal, claims recovery and programming experts. We have 15 years of health payor industry knowledge. With over 15 years of experience, SOCRATES, INC. serves the healthcare payor industry and has a diverse customer portfolio, including health plans, third party administrators (TPAs), self-funded welfare benefit plans, Medicaid and Medicare products and governmental plans. Providers such as WellPoint®, Definity Health, Inc., John Deere Health, UnitedHealthcare®, Meritain Health, f/k/a North American Health Plans, along with a variety of BlueCross BlueShield licensed plans, have benefited from SOCRATES, INC’s outsourcing services and software. Socrates can be reached at 1.800.653.3144 or www.socratesinc.com. | 
| Client Services | visit this site | | Founded in 1989, FlexTech currently serves a client base of more than 200 pre-eminent healthcare organizations throughout North America. Our extensive knowledge and depth of staff means we can support most companies through a seamless transition from current to desired information technology capabilities. Our senior business consultants bring extensive healthcare perspective and large-scale system experience to each engagement. Our accumulated knowledge and depth of staff also means we can provide on-site professional system and applications support targeted for specific needs on a short- or long-term basis. Utilizing this experience, we help clients achieve their goals, deepen their knowledge and understanding, and enable them to maximize their own valuable personnel and budget resources. |  | Care and Disease Management Solutions | visit this site | | ZeOmega, based in Texas, is a premier provider of software solutions for Integrated Healthcare Management. ZeOmega's suite of care management software, which includes EHRs, personalized care plans, decision support tools and portals, transforms traditional episodic-based care management into proactive and collaborative population healthcare management. |  | data analytics | visit this site | | We bring together all your healthcare data into one location. We then clean and validate it and organize it in a simple to access way that allows you, your HR staff, CFO, benefit administrator, benefits advisor and outside consultants to see how your health plan is doing - every day. We call this transparency – healthcare cost transparency. And we believe this is absolutely necessary to manage and control heatlhcare costs. We ask our customers a simple question: |
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