Health plans continue to invest in their claims systems focusing on automation of healthcare claim processing to improve turnaround time and claim throughput.
Changing regulatory standards are forcing healthcare payers to make considerable investment not only in building new systems, but also in focusing on integrating it with provider and third party system for faster claim processing, and thus increasing the rate of electronic claim submission.
Having partnered with multiple healthcare payers and revenue cycle management companies we understand the challenges involved in the claim management space and help you address newer challenges while increasing the efficiency of claims processing.
Our years of experience working dedicatedly on US healthcare space has helped us offer a range of solutions such as revenue cycle management, health insurance claims processing, over-payment analysis, and QA automation.
Leveraging our experience in claims management we offer a range of services:
- Claim process re-engineering
- Legacy modernization for claim re-platform
- New system implementation
- Regulatory compliance consulting
- Building and maintenance of claim management platform
- Customizing package products like Trizetto facets
- Development and testing of new claims system
- Integration with third party system
- BPO services for over-payment analysis
- Eligibility verification
- Claim adjudication services
- Advanced BI and analytics
- Data management services
- Medical authorization review
- Co-ordination of Benefits processing
- Expert inputs from our healthcare CoE to improve the quality of the process
- Our SMEs and healthcare technologists having knowledge on claims management ensure easy on boarding and faster knowledge transfer
- Repository of claims analysis scenarios and test cases
- Development framework for Business Intelligence platform for claims data analysis