Claims Processing
Claims management services consist of advice or services in respect of claims for compensation, restitution, repayment or any other remedy for loss or damage, or in respect of some other obligation.
Life cycle of Claim Management
Claims Follow-up
- Every unpaid claim is checked on weekly basis
- Building efficient relationships with vendor
- Ability to update interested parties on the status of a claim
- Resources to deal with denied and rejected claims
- A consistency and method to follow up means money is well spent. Imagine a specialist, with the background in your facility’s area of medical expertise, which you trust to represent your clients and advocate on their behalf.
Review Industry information and Trends
- Changes to insurance laws
- Introduction of new technology
- Changes to medical coding and diagnosis changes
Features
- Demographics and signature capture at admission point
- Insurance cover validation in real-time
- Aggregation of clinical summary for provider/physician billing
- Consultant/Physician signature support for claim approval
- Reconciliation of physician code charges to provider codes
- Invoice generation from source data as desired
- Pre-submission validation of claim to reduce rejections, returns
- Code libraries tailored to end-users
- Progressive elimination of paper from the entire revenue cycle process
- Automated reconciliation of payments/denials/returns
- Leverages existing technology infrastructure with tight integration