BPO Services

Our healthcare business process outsourcing (BPO) team can implement the processes and technologies for health plans that bring about real transformation for customers of all sizes.

Our end-to-end administrative services help you streamline operations, improve productivity and strengthen cash flow to stay competitive and improve member satisfaction. We can help you work smarter by reducing the cost and make the best use of your staff members by putting their time and resources toward crucial areas such as claims management, care management or member and provider relations.

Payer Services

Our healthcare business process outsourcing (BPO) team can implement the processes and technologies for health plans that bring about real transformation for customers of all sizes.

Our end-to-end administrative services help you streamline operations, improve productivity and strengthen cash flow to stay competitive and improve member satisfaction. We can help you work smarter by reducing the cost and make the best use of your staff members by putting their time and resources toward crucial areas such as claims management, care management or member and provider relations.

  • Medical Claim Data Entry
  • Data Processing of all Medical Insurance Claim Forms, including UB-04, HCFA, CMS-1500, UB92, Dental Claims Forms
  • Medical Claim Data Indexing / Extraction and Triaging
  • Medical Claim Data Validation
  • Provider and Member Data Maintenance and Cleansing
  • Policy Owner Services
  • Claims Adjudication
  • Medical Claims Administration Support Services

Industries

Health Insurance
Pet Insurance
Dental
Vision

Revenue Cycle Management Services

Our RCM practice offers end-to-end revenue cycle capabilities delivered by experienced RCM professionals. Our certified & skilled workforce, continuous improvement models, strategic quality control mechanism, and integrated analytics enable our clients to achieve and sustain their improved revenues at a lower operative cost.

Patient Access & Eligibility
  • Demographics data entry
  • Collecting and verifying patient information (demographics, insurance, etc.)
  • Eligibility verification and prior authorization
Pre-Authorizations
  • Identify the need for Authorization
  • Obtaining the Prior Authorization based on the Medical Necessity
Medical Coding & Charge Entry
  • ICD-10, CPT, HCPCS coding
  • Accurate charge capture and compliance
Charge Capture
  • Recording of services provided during a patient visit
  • Ensuring all billable services are documented correctly
Claims Submission
  • Preparing and submitting claims to insurance companies or payers
  • Ensuring claims are clean and compliant to avoid denials
  • Rejection management and re-submission
Denial Management
  • Analyzing and addressing denied or rejected claims
  • Re-submitting corrected claims as necessary
  • Sending patient statements
  • Managing payment plans and collecting outstanding balances
Payment Posting
  • Applying payments to the correct accounts and invoices
  • Recording payments from insurance companies and patients
  • ERA/EOB processing
  • Patient payment tracking
A/R Follow-Up & Denials
  • Timely follow-up on unpaid claims
  • Appeal process for denied claims
Enrolment
  • Enrolling the patient into the in healthcare Insurance
  • Fill up the Healthcare Insurance Forms
  • Choosing the Plan
  • Submitting the Application

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