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Healthcare providers often struggle with the medical claims processing that involves submitting claims with documentation to the relevant insurance company. The claim details should have the cost of the services provided and verify that the services are covered under the patient's health insurance policy. Then healthcare providers receive payment for their services, once the claim is approved. To approve this claim, there should be accurate details to reimburse timely.

Are you struggling with coding errors in your insurance claims? Are claim denials slowing you down and affecting their bottom line? Our team's expertise in precise coding, speedy claim submissions, and efficient denial management results in streamlined operations, faster reimbursements, and improved financial health.

Experience the benefits of outsourcing your claims processing to us - your partner in maximizing efficiency and profitability. Reach out to us today!

Client Success Stories

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Cost-Effective Insurance Eligibility Verification Services to a Telemedicine Provider

A leading birth control telemedicine provider was looking for a service provider who could help them with insurance eligibility verification services. Our team provided the client with cost-effective services.

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Flawless Demographic and Charge Entry Services with Strict Deadliness

A leading client was looking for a partner who could process more than 17000 claims in a month using the Kareo software. Our team provided the services within a quick time.

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Success Stories

Our Comprehensive Medical Claims Processing Solutions

Improve your cash flow with secure, compliant, and timely processed medical claims. Our end-to-end services include -

Insurance Eligibility Verification

Insurance Eligibility Verification

We scrutinize the patient's insurance coverage to confirm eligibility for the claimed medical services to avoid unnecessary claim denials.

Coverage Assessment

Claim Adjudication

Our team reviews every claim, determining the insurance company's payment responsibility. We ensure that you receive the correct payment for the services provided.

Claim Disbursement

Claim Disbursement

We ensure hassle-free payment processing by managing the release of funds from the insurance company. Minimize uncharacteristic delays and optimize your financial performance with us.

Payment Collections

Medical Claims Data Entry

Our team enters all relevant details about a patient's diagnosis, treatment, and insurance, laying a solid foundation for a successful claim submission.

Claim Document Imaging

Claim Document Imaging

We convert all claim-related documents into digitized images, enabling easy retrieval and efficient handling of your claims.

Claim Support & Auditing

Claim Support & Auditing

We provide robust support throughout the claims process and conduct in-depth audits to guarantee compliance with regulations.

Payment Collections

Medical Claims Administration Support Services

We take over the comprehensive management of all aspects of your claims process, from claim submission to follow-ups, denial management, and appeals.

Medical Claims Data Indexing Services

Medical Claims Data Indexing Services

Our team categorizes and organizes your claim data for easy retrieval, providing you with efficient data management and quick access to necessary information.

Medical Claims Data Processing Services

Medical Claims Data Processing Services

We process all your claim-related data, including patient information, diagnoses, treatments, and insurance details, preparing your claims for successful submission.

Medical Claims Data Validation

Medical Claims Data Validation

We validate claim data for accuracy and completeness, helping you to minimize errors and maximize your claim acceptance rate.

Our Integrated Medical Claims Processing Process Flow

Our process enhance accuracy and completeness helping you to minimize errors and maximize your claim acceptance rate -

1

Claim Reporting

2

Documentation

3

Claim Evaluation & Processing

4

Payment or Denial

5

Appeals and Settlement

6

Claim Closure

Why Choose Us as Your Medical Claims Processing Company?

Our team consists of expert professionals with 20+ years of experience in medical claim processing. Their expertise can help streamline your claims submission, reduce stress, and increase productivity.

Our Software Capabilities

NextGen Healthcare kareo billing ehr eClinicalWorks AdvancedMD Brightree Medisoft Athena Health Mediatouch Athenahealth Billing Ehr AdvancedMD Billing epic Billing Advantx Billing CareCloud Billing Centricity Billing Lytec Billing Misys Billing Modernize Medicine Billing Nextech Billing Proclaim Billing Pulse Sequelmed TotalMd Billing

Additional Services We Can Benefit From

Streamline your financial decision making with our expertise in payer contract management and advanced analytics.

We improve your cash flow and reduce denials by ensuring accurate billing and CPT coding. We streamline your billing process and manage regulatory changes.

Our experts focus on improving the first-pass resolution rate, identifying denial patterns, and implementing effective corrective measures for revenue enhancement.

Ensure seamless transactions and patient satisfaction with upfront patient eligibility checks. Reducing bad debt and improve the patient financial experience resulting in streamlined workflow.

Enhance diagnostic capabilities reducing patient wait times with digital sharing of medical images enabling prompt diagnosis.

We focus on reducing A/R days, negotiating skillfully with insurers and minimizing write-offs.

Boost your cash flow with our relentless follow-up on unpaid claims.

Outsource Medical Claims Processing Services to Us

Gain access to prompt and efficient medical reimbursement services by choosing us for claims processing outsourcing. Our solutions are designed to streamline your operations, reduce errors, and expedite payments. Our integrated process flow starts with documentation, adjudication, and settlement, culminating in swift claim resolution. Our services stay compliant with all regulations, avoiding potential legal issues.

Our healthcare claims processing services are powered by advanced claims management software solutions. The software we use checks for industry-standard compliance and payer-specific guidelines. From acceptance to adjudication and final settlement, the software tracks claim in real time, making it easier for us to track denial patterns and operational bottlenecks.

Let us handle the complexities of claims processing while you focus on what you do best - providing quality healthcare.

FAQs

Medical claim processing services are specialized services that handle the entire lifecycle of a medical claim - from creation, submission, follow-up to final settlement with insurance companies.

The core benefits are increased operational efficiency, reduced claim denials, significant cost savings, and improved focus on patient care.

Our pricing structure is based on per-claim basis and is fully transparent. We discuss all costs upfront, ensuring there are no hidden charges.

We use advanced software and systems such as practice management systems (PMS), electronic health records (EHR), and advanced coding tools for efficient claim processing.

We prioritize data security and comply with stringent data privacy regulations like HIPAA. Our measures include secure data transmission, encrypted storage, and regular security audits.

Our services are scalable and can handle large volumes of claims. The number of claims we can process is flexible and can be adjusted according to your needs.

Absolutely, we tailor our services to match the specific needs of each healthcare provider, ensuring a personalized and efficient claims processing experience.

Medical claim processing services are integral to healthcare RCM as they ensure quick and accurate reimbursement for services provided, improving cash flow and revenue.

We strictly adhere to all relevant regulatory standards and keep abreast of changes in regulations through continuous education and industry updates.

Our services include detailed reporting and analytics that provide insights into claim status, financial performance, denial reasons, and other key performance indicators.

Avail best-in-class services at affordable rates

Starts @ $1280-1440 per FTE/month More details

Our Customers

Movement Mortgage
Alcon
ARI
Maximus
Redwood E-Learning Systems

AHIMA Healthcare Convention 2016

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USA

Flatworld Solutions

116 Village Blvd, Suite 200, Princeton, NJ 08540


PHILIPPINES

Aeon Towers, J.P. Laurel Avenue, Bajada, Davao 8000

KSS Building, Buhangin Road Cor Olive Street, Davao City 8000

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