Claims Administration

A Seasoned Leader in Government Healthcare Claims Processing

With 40+ years of experience, PGBA quickly, securely and accurately processes more than 60 million claims annually. Our strength lies in using robust, flexible technology to tailor applications to each customer’s requirements.

We’ve designed a HIPAA-compliant operating platform that offers powerful processing capabilities while remaining flexible and adaptive. Our system scales to process, analyze, and report on high volumes of claims data according to customers’ business rules. PGBA's technology has embedded security that consistently exceeds government requirements.

Key Advantages:

  • 99% of claims resolved in 30 days or less
  • 99.8% payment accuracy rate
  • Compliance with NIST, HIPAA and CMMI
  • Scalable solutions to support changing capacity needs
  • Multiple channels and methods for claim submission
  • Automated claim adjudication
  • Skilled, customer-focused advocates with 10+ years average tenure
  • Controls for monitoring and reporting on volume and timeliness

Let’s talk about better ways to serve your plan members and providers.