CLAIMS ADJUDICATION: We are a new-age medical claims process outsourcing company. In a short period of time, we have already established ourselves as an experienced player in insurance claims adjudication. We process and adjudicate medical claims by implementing those methods and systems which are HIPAA-compliant. Our processing period complies with CMS guidelines. Our team of claims adjudicators is highly skilled, familiar, and trained in most of the industry standard adjudication software and is flexible to adapt to any adjudication system within a short stint.Credentialing: Credentialing is the process of procurement, authentication and evaluation of a provider’s eligibility and determining whether an applicant is eligible to become a participating provider with the organization. We provide groups and clients with a complete range of credentialing services through a proven and reliable system that ensures organisational providers comply with state and regulatory bodies before directing membership to these facilities.
BILLING/COLLECTION: Our Billing and Collection team provides tailored and customized pivotal solutions to Medicare and Medicaid HMOs. We also offer Commercial insurance plans and PBMs, empowering them to attain sustainable results. Our certified public accountants and financial experts handle each process with the help of our meticulous, robust data centre and modern, new-age, state-of-the-art technology. We are competent and prepared to manage and take care of all the needs of our clients by providing them with seamless, efficient full-cycle billing and collection solutions in an astonishingly cost-effective manner.
Utilization Management: Utilization Management is the analysis of the aptness and medical need of health care services, procedures and facilities according to the predetermined criteria or rules and under the provisions of an applicable health benefits plan. It is a critical and essential component of the healthcare system in the US and needs proficient expertise to a great extent. We offer our clients a dedicated and specialized range of Utilization Management services for Part A, B, and D. We provide accurate, meticulous and timely reports curated by qualified medical professionals to empower you with reliable, cost-effective Utilization Management solutions.
Contact Center: We offer you a dedicated, specialized, highly skilled, trained, experienced, large team of Customer Care personnel to take care and deal with all the issues related to your medical billing service cost-effectively under a single roof.