Streamline Claims Processing with
Precision and Efficiency
Monument Xpress™ Core Claims System is a modern, comprehensive software platform that manages and streamlines the entire insurance claims lifecycle. It is typically used by health plans, third-party administrators (TPAs), and self-insured entities to improve operational efficiency, reduce manual effort, and deliver faster, more accurate claims processing.
Boost Automated Claims Processing Rates
Whether you're working in Medicare, Medicaid, Commercial lines of business, or you're a specialty health plan, your auto-adjudication rate has the potential to exceed 90%. With just six months for implementation and another six months of using Xpress™, we’ll streamline your claims submission process, automate prior authorizations, and eliminate redundant administrative tasks—driving faster, more accurate claims adjudication and reducing manual workload.
Scale with Best-In-Class Industry Support
Planning to implement a new medical claims system? Monument Xpress™ is a feature-rich, modern core adjudication platform built on a robust relational database backed by unmatched industry support. Designed for scalability and performance, it continuously evolves with innovative enhancements to meet the ever-changing needs of health plans.
“We will finish our claims implementation in about eight months, which is highly unusual in the industry. If you factor in that the same Monument team simultaneously implemented prior auth, fax api, BPO for a Tucson and India office, and delivered reporting at the same time, this is extraordinary. We contributed roughly two SMEs per subject area and a vice president to manage the project, but for two lean organizations, this is a huge volume of work that we accomplished in addition to our day jobs at the health plan, and did you notice that there was not a heavy lift with IT? I give kudos to both teams for pulling this off.”
Enhance Quality Care with Integrated Information and Medical Management
Monument Xpress™ consolidates clinical and administrative data, enabling real-time medical management by combining claims adjudication with medical necessity reviews seamlessly. This integration enhances care quality and improves routing, eligibility checks, and audit workflows.
Build Better Processes with Workflow Automation and Our Flexible Rules Engine
Built with an embedded workflow engine, Monument Xpress™ automates manual processes from claims routing to exception handling, reducing manual effort and human error. Claims workflow adapts to plan-specific rules and scales across products.
Generate a Full Audit Trail and
Reporting
Every claim is processed with complete audit tracking and quality checks. Xpress™ supports comprehensive reporting, allows auditing at any point, and ensures transparency — essential for compliance with payer and regulatory standards.
Manage Benefit and Billing
Management
Xpress™ manages premium billing, payments, reconciliation, and bad-debt handling.
Grow Together with Our Scalable Architecture
Suitable for various lines of business e.g., Medicare, Medicaid, Commercial, or various plans e.g., healthcare intermediaries such as TPAs, IPAs, MSOs, and ACOs, with flexible contract and benefit models.
Gain Insights with Elevated Reporting
If your health plan is relying on older core systems, receiving data from multiple payers or clearinghouses, or working with third-party administrators or analytics systems, there is a high likelihood (70–90%) that you’re facing limited reporting and transparency without targeted remediation. Monument Xpress™ has over 300 reports out of the box, plus the ability to create custom reports. Our AI-powered reporting improves over time as the system learns your organization’s data patterns.
Grow with a Unified System
With Monument Xpress™, you get continued evolution and innovation to the product, advanced AI, exceptional customer service, a six-month implementation on average, and a 90% adjudication rate after six months of working with us.
Claims Processing Features Built for Accuracy
- ›Adjudicate claims accurately against contract terms, coding guidelines and benefit structures
- ›Prevent errors using rules engines and edit checks
- ›Reduce manual interventions
- ›Ensure regulatory compliance e.g., CMS, HIPAA
- ›Set up all groups and contracts
- ›Manage all benefit design
- ›Process all claims with full auditing and quality checks
- ›Gain insights with full reporting
- ›Process EOB and all other required Member or Provider required
- ›Manage BPO services (e.g. claims, prior authorization) onshore and offshore
- ›Manage with a modern user interface
Our Modules - with or without BPO Services
Monument Xpress™ Claims
Xpress™ is a fully loaded core claims processing system but implemented in half the time, and at half the cost.
Learn MoreXpress™ Auth
AI-driven prior auth automation that accelerates approvals, ensures compliance, and improves provider and member experience.
Learn MoreXpress™ Communication
Secure, intelligent fax and communication automation that eliminates manual handling and integrates with plan workflows.
Learn MoreXpress™ Enroll
AI-driven enrollment for Medicare, Medicaid and Commercial lines of business. Connect direct with CMS.
Learn MoreXpress™ Appeals & Grievances
AI driven for more accurate case resolution while ensuring complex regulatory requirements and deadlines.
Learn MoreXpress™ Clinical Assistant
Standalone AI web + mobile tool for clinical decisions. Human-approved for Prior Auth and Clinical Appeals.
Learn MoreXpress™ Intake
Automate and categorizes intake from multiple channels (portal, fax, email, EDI and API), validates eligibility, classifies and routes it forward.
Learn MoreXpress™ Workflow
Configurable web + UI to build and link tasks into workflows. Models improve with time and usage.
Learn More