Things become more challenging and difficult to manage because ether is many issues in healthcare services. The need for valid and efficient adjudication services has been raising. That is why Beeptech has the healthcare claims and adjudication services to serve our clients in this regard. Our team of experts manage the medical claim by performing adjudication to reduce fraud, expenses, and improve productivity with pocket-friendly features. We work in a way to tackle all your issues of adjudication problems and make the thing more inflow for better running of your healthcare institute. Are you fed from the dependency of adjudication on internal staff? Are you facing the loss of productivity? Is there any issue and errors in your claims processing ? Are you really looking to boost your healthcare services, then, avail of our healthcare claims adjudication services. We have a bunch of benefits that you can tool to get amazing benefits for your clinical setting efficiently.
We function dynamically to improve productivity a workflow without causing any hassle and delay. We manage all kind of claims either they are manual or electronic. We scrutinize the claims record for accurate submission of patient names, diagnostic codes, and then, process claims. The claims made in this way are more precise and free of errors wich help for valid reimbursements. Our team of professionals minutely check all the claims and reduce the errors, duplication, and rejected claims. We make the claims so transparent and accurate that no more claims are rejected and give you productivity support. Thus, you can avail of more benefits with our services.
Our Healthcare Claims Adjudication Services
We have a skilled and well-trained team of medical claim examiners. They are backed with the experience of many years in manual and electronic claims adjudication. Our serving capacity is amazing, and we are associated with many hospitals all across the globe. We make sure that our customers get the advanced and latest technology for their healthcare claims adjudication. For that sake, we keep our professionals and technology updated to meet the challenges of the current scenario. We offer the following Healthcare Claims Adjudication Services.
- Medical Claims Processing
- Remittance Processing
- Medicare Reimbursement Services
- Dental Claims Adjudication Services
- Determination of benefits
- Verification of provider details
- Detection of fraudulent claims
- Ensuring correctness of raw claims data
- Performing rule-based edit
- Eligibility Checking
- Verification for duplicate claims
- Recommendation of changes to rejected claims
- Adjudicated Claims Types By Beeptech
We adjudicate the following claim types for customers and clients. Although we have a wide range of services for clients along with these. They are:
- HCFA 1500
- CMS 1500UB92
- B04Dental Claims
- Pends Correspondence
- Enrollment Forms Processing (EFP)
- Vision FormsMiscellaneous (Complex / Non-standard)
- PPO Repricing
- Forms Processing
- Insurance Fraud Detection
- EDI Integration
Process of Our Healthcare Claims Adjudication Services
The process of Healthcare Claims Adjudication Services is more comfortable and convenient to comprehend by customers. We understand the importance and worth of these services; that is why we assure experienced, and skilled professionals work to resolve your adjudication issues. We handle complicated things with delicate and efficient services with a minimal time range. Our process is systematic and streamlined to manage the healthcare claims adjudication services. The things included in our working process is:
Initial Review of Processing
This is the first step by which we check entirely the claims to make them free of errors and omissions. The claims checked and corrected thoroughly and resubmitted for a revenue boost. Any error such as wring name, code, or patient details can utter claim into denial or lead to rejection. But, we make sure that each claim is checked and properly evaluated in the initial to avoid the chances of errors.
Check Claims According to Policies
At this step, we check the claims to verify according to policies. If any error occurs, we try to repair it by correcting them appropriately. This automatic review has:
- Patient eligibility on the date of service
- Authorization and pre-certification absence
- Invalid authorization and pre-certification
- Claims duplication
- Crossed the filing deadline
- Invalid procedure or diagnosis code
Use of Manual Review
This step requires a manual review of the things. All the medical claim examiners check the claims manually and correct them. This is common with eth doctors or nurses to check the medical documentations manually.
Payment Determinants
We use the sources to get an idea about the payment determination. We make sure that you get full payment of your revenue. We have three types to analyze payment. They are:
Paid
The payer determines if the claim is reimbursable in case of showing paid.
Denied
In case of a claim is denied, the payer determines that the claim is non-reimbursable.
Reduced
The reduction is made to manage the cost. If the billed amount is too much for the diagnosis, then claims examiner can use down-code to put it at a lower level.
Payment
The insurance payer submits the payment to the medical care provider and follows the below data:
- Allowed Amount
- Covered Amount
- Patient Responsibility Amount
- Approved Amount
- Payer Paid Amount
- Discount Amount
- Adjudication Date
Our Healthcare Claims Adjudication Services Features
We have the skills and expertise in our professional team. Our experts function eagerly to provide the following features.
ISO Certified Claims Adjudication Services
Our healthcare claims adjudication services are an ISO 9001:2015 certified. Our company knows the importance of working with legal things. That is why we ensure high-quality service to make the claims adjudication services more beneficial for our clients.
Pocket-friendly Services
Our Healthcare Claims Adjudication Services aim to set ease for our customers. We have all kinds of offers for our clients at affordable prices.
Security of Data
We work with an ISO/IEC 27001:2013 ISMS certification and keep your information and details confidential. We follow the agreements and have data security policies to protect your data from hacking and misuse.
HIPAA Compliance
Our Healthcare Claims Adjudication Services is compliant with the HIPAA agreement to ensure a safe and secure working capacity.
Advanced Technology
We have the latest and updated versions of the claims adjudication software and tools to make use of the best technological advancements.
Quick delivery
The best thing about our Healthcare Claims Adjudication Services because we give you before time delivery of your project completion. Wo do not delay your order and function as per your requirements.
Dedicated Single Person
After having our services, you can have our professional managers who only deal with you and reduce your queries for better communication.
Skilled Professionals
We have qualified, and skilled team of adjudicators who are talented, qualified, and experienced professionals in this field.
Customized Services
Our Healthcare Claims Adjudication Services are customized and easily manageable according to your requirements. Make sure that you get the desired level of benefits and comfort with our services.