Payers services
Member Enrollment
Medicare beneficiary enrollment services is a perfect balance of strategic scrutiny along with implementation of best practices in the healthcare sphere; and has won us market presence in the enrollment processing. Our value adds has always won us long term relationship with our clients.
Claim Recovery Service
Client specific and tailor made claim recovery service plan, delivering results surpassing industry standards.
Preloading
We predict denials prior to submission by closely monitoring the susceptible areas in claim processing evading errors and improved payment timeframe. The exclusive web-based pre-adjudication system increases profitability with the identification of preventable denials and provide solutions before claims are submitted to payers.
Claim Adjustments
Our team of experts do not leave any stone unturned in identifying overpayments; these identified amounts are deducted from future claims.
Claim Adjudication
The patient eligibility & claim verification process involves several intricate details that need to go under the scanner to determine an individual’s coverage details and ensure clean claim avoiding denials. Our approach involves proprietary software and client-based software to find duplicates using a matching algorithm.