Claims Adjudication Services

Healthcare claim adjudication can become messed up if efficient processes are not adapted to manage it. Things must be managed properly, or else there can be huge problems. Problems may be manifested in the form of duplicated claims, unwanted claims, much-delayed execution of claims, etc. All such things will directly impact your profit. Now you can streamline claims adjudication by opting us as your partner.

Outsourcing Desk has real experts who have been delivering claims adjudication services since 15 years to global clients in the medical insurance industry and healthcare industry. Now you need not carry out such non-core tasks in your organization as you may leverage on our claim services. We have a dedicated team of adjudicators to support you all throughout the adjudication process. Our team will act as your in-house team of claim adjudicators.

A range of claim adjudication services

We have been providing high-quality services relating to claim adjudication for 2 decades by now. Since we are here in the industry for decades, we have the needed experience or knowledge to carry out adjudication process or cater to the specific needs of our clients. If you are an insurance company flooded with volumes of claims that are unprocessed, we can manage everything for you. With the team of excellent adjudicators, we can efficiently manage claims. We can help you out with the following claims:

  • Dental claims
  • HCFA 1500
  • CMS 1500
  • Enrollment files processing
  • Miscellaneous forms
  • Vision forms
 

We have the needed skills and expertise to offer our clients the following services:

  • PPO Repricing
  • EDI Integration
  • A complete medical claim processing
  • Fraud detection

What process do we follow?

When you approach us for claims adjudication, we follow a series of steps:

  • We find about the eligibility of the form whether it is eligible for processing or not
  • Any duplicate in the claim will be found out through a thorough evaluation
  • The next step is proper coding and bundling. We then review the claim
  • We have the team of healthcare experts to carry out a detailed analysis of care organization or the hospital.
  • We then check whether the claim is valid for adjudication or not. We also evaluate the benefit of processing it
  • Some changes may be made to the claim in the last stage. This is done according to the rules and regulation of the industry

Why should you choose us?

There are various reasons why we are preferred option among our clients. The following are some of them:

  • Our services are extremely affordable, and billing is done as per the claims processed each day
  • We make sure that the data remain safe and secured. We adopt data security policies
  • Our services and policies comply with HIPPA.
  • We use our state-of-the-art infrastructure to offer best services
  • Our turnaround time is extremely quick
  • We make use of updated and latest versions of software

We have qualified, skilled, experienced and talented team of adjudicators. Get in touch with us now.