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Transform the Claims Management process by mitigating risks and ensuring complete accuracy in critical forms like CMS 1500 (HCFA), CMS 1450 (UB-04/UB-92), etc. Refurbishing the claims submission processes by efficient EDI interoperability. Reorienting claims adjudication processes through digitization to ensure HIPAA-compliant error-free outcomes while undertaking quality checks to deliver 99.5% accuracy.
Paper claims for HMOs, TPAs, or insurance carriers received in the mailroom are indexed/triaged, scanned, and routed to the relevant stakeholders for further action. Undertake mailroom operations like scanning, sorting, indexing, and other data capture activities.
Online and off-line services for entering various claim forms like CMS 1450 (UB-04/UB-92), CMS 1500 (HCFA), Dental, Medicare Supplement, Tricare, COB and COB with EOB, Accident forms, and Repricing, etc.
Organized EDI processes ensure better interoperability between patients, healthcare providers, and insurance providers. We adhere to acceptable X12 EDI transactions of 837I, 837P, and 837D.
Our auditors scrutinize claims processed by examiners against various quality checks. Once the claims have been audited thoroughly, they are ready to be released for final payment.
Ashish has over 20 years of experience in strategic insight, business development, service delivery, change management and strategy formulation. He is currently responsible for Business Development for Healthcare, Insurance, and F&A services.
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