Outsource PPO Health Insurance Claims Repricing Services

PPO Health Insurance Claims Repricing Services

Outsource PPO health insurance claims repricing services to Flatworld Solutions and get access to the best alternatives to traditional health insurance plans at prices starting at $1280 per FTE per month

In the United States, one of the major reasons why people stay uninsured is the cost of health insurance plans. The most viable solution to such a problem is medical repricing services. Thought to be the best substitute for traditional health insurance, a greater number of health insurance providers are seeking health insurance claims repricing. One of the popular ways of repricing is preferred provider organizations health insurance claims repricing, or more commonly known as PPO health insurance claims repricing. In this plan, there is a fixed fee structure that applies to medical claims. This lets insurance providers provide a discount on payable claims by restructuring. While the most apparent benefits include access to reasonably priced health insurance for individuals and companies, easy and fast fraud detection, accurate billing, and in-depth analysis of insurance data, the task of medical repricing can be time-intensive, tiring, and complicated. This is why working with a professional PPO health insurance claims repricing service provider can be useful for you.

Flatworld Solutions is a preferred PPO health insurance claims repricing services providing company due to its vast experience. We work with a large team of experts who have the skillsets and knowledge to help you with the process of PPO health insurance claims repricing, thus helping you save time, cost, and effort. We make use of the best tools and follow industry standards to ensure you have access to high-quality PPO health insurance claims repricing services when you work with us.

PPO Health Insurance Claims Repricing Services We Offer

Flatworld Solutions provides comprehensive PPO health insurance claims repricing services to help you operate in an error-free manner. A majority of hospitals and healthcare organizations use modern systems for claims processing. However, while working with advanced billing management software and tools, and when handling a heavy workload, there are more chances of errors.

Additionally, being a part of the PPO network for a healthcare system comes with a load of handling claims repricing paperwork. This paperwork leads to higher operational costs, and when you partner with us, we help you avoid additional costs while at the same time reducing the burden of the claims repricing process as well. Here are the PPO health insurance claims repricing services we offer -

Manual Claims Repricing

Manual Claims
Repricing

Checking and Verification of Claims

Checking and Verification of Claims

End-to-End Processing of Medical Claims for Health Insurance Claims Repricing

End-to-End Processing of Medical Claims for Health Insurance Claims Repricing

Routing of Claims to the PPO for Repricing

Routing of Claims to the PPO for Repricing

Claims Validation

Claims
Validation

Provider Table Maintenance

Provider Table Maintenance

Processing of forms

Processing of
forms

Detection of Fraud

Detection of
Fraud

Our PPO Health Insurance Claims Repricing Process

While PPO health insurance claims repricing happens for existing products, collecting the right data is always an indispensable part of the process. Flatworld Solutions utilizes its experience and the experts from our team come together and break down the whole process into smaller steps to carry out the operations in a systematic manner. This helps us render improved customer services. Following are the core stages of our PPO health insurance claims repricing process -

 

01. Collecting Data for Insurance Repricing

The most effective way to come up with reliable insurance estimates is to have access to reliable data. We understand the different ways of data organization from database management systems to TPA databases and frame a useful strategy that ensures there is no loss of information or data. The process is highly streamlined, secure, and efficient to ensure the accurate collection of high-quality data

 

02. Hospital and Insurance Data Reconciliation

We perform rigorous checks to prevent the chances of data loss. This is why data reconciliation is a core part of our repricing process. To state an example, when we access TPA based data, we perform a data reconciliation check on various levels from the stage of transferring data, after the data reaches the insurer, and then finally another reconciliation check when the data is to be presented for claims repricing

 

03. Data Cleaning and Restructuring

After the transfer of the data, we initiate the data cleaning and restructuring process for improved analysis. Some of the corrections that we make while cleaning and restructuring are correcting errors, elimination of duplicate records and working on data mismatch, and data standardization. These efforts help ensure that the repricing happens seamlessly

 

04. Insurance Data Analysis

This is the final stage wherein we check for various details such as the number of claims, paid amounts for each claim, policies issued, and the number of people insured, among others. These details are compared against a range of parameters like claims per band, age bands, amount insured, etc. This helps in ensuring the accuracy of the claims repricing so that you find it more convenient to understand and follow the repricing

PPO Health Insurance Claims Tools We Leverage

As a professional PPO health insurance claims repricing service provider, we know how to make our services more efficient, and as a result, more reliable for clients. We invest in some of the most advanced and high-quality tools and software that ease the operations. Our expert team keeps abreast of all the updates and we also train our professionals from time to time to render perfection to our PPO health insurance claims repricing services. Following are some of the tools that we deploy -

Kareo Billing & EHR eClinicalWorks MediTouch brightree AdvancedMD NextGen healthcare AdvantX Billing AdvancedMd Billing Centricity

Other Services You May Be Interested In

Why Choose Flatworld Solutions for PPO Health Insurance Claims Repricing Services

Flatworld Solutions is a reliable PPO health insurance claims repricing services providing company with the experience of working with countless hospitals and healthcare practices. We can make the process of repricing error-free, accurate, easier, and more cost-effective for you so that you can focus on the core operations of your healthcare organization. Following are some of the benefits of outsourcing PPO health insurance claims repricing to us -

  • Affordable Pricing Solutions

    We provide fair cost estimates after assessing your requirements so that budget never becomes a constraint for you to access effective PPO health insurance claims repricing services. Our pricing is straightforward and we are completely transparent about the costs; therefore, there are no hidden costs.

  • HIPAA Compliance

    Before we start any project, we make it a point to first sign the HIPAA agreement to ensure that all the data on patients is safeguarded from access by third-party organizations.

  • Complete Data Security

    We understand that you share confidential data and information with us and put your confidence in us. We adhere to stringent data security policies and protect your data completely from third-party access at all times.

  • Well-Established Infrastructure

    Our team of seasoned medical billing experts have access to best-in-class infrastructure and are equipped with all facilities such as 100% power backup throughout the day, uninterrupted network, billing and coding systems and software, and much more so that we can offer you unbeatable PPO health insurance claims repricing services in a hassle-free manner.

  • Quick Turnaround Times

    We have a combination of an experienced and knowledgeable team of professionals who work with passion and diligence and use the latest tools and technology. This combination speeds up the process of claims repricing and helps us offer quick turnaround times without compromising on the quality of our services.

  • Regular Reporting

    To ensure complete transparency and keep the client in the loop all the time, we assign you a project manager who will get in touch with you to keep you updated about the progress of the project.

  • 24/7 Support

    We have a team of expert customer care service providers that is available around the clock to address queries and provide information related to our services. You can reach out to us via calls or drop us an email. We will get back to you in a short while irrespective of your time zone.

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Outsource PPO Health Insurance Claims Repricing To Flatworld Solutions

Testimonials

I am highly impressed with the quality of the work and your attention to detail.

Owner,
Diagnostic Care, USA
More Testimonials »

PPO health insurance claims repricing has great prospects for making health insurance affordable and accessible to a greater number of people. However, for healthcare systems, it can add a significant burden as it involves strenuous, complicated paperwork. Even a little error can cost you a lot of time and money. This is why working with a professional PPO health insurance claims repricing services providing company like Flatworld Solutions is a wise decision. Not only do we help you save costs as a result of removing errors and inconsistencies, but we also help lessen the burden that rests on your shoulders.

Get in touch with us now to outsource PPO health insurance claims repricing services at affordable rates.

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