Uniquely Experienced in Claims Administration

Timely and accurate payments are the linchpin of the payer-provider relationship. Your customers also count on you to process their claims accurately and timely to minimize their out-of-pocket expense to the contracted amount. We adjudicate claims using a first in, first out method, follow up regularly on claims pended for review and process payments in small batches to keep payments flowing to providers.

Quality customer services is imperative to any operation. We have experience setting up customized contact center structures and procedures and can assist by providing services for multiple specialties, including Medical, Dental, Behavior Health and Pharmacy services. Services are customized based on service type, provider preferences, and other unique processes and requirements. Standard Operating Procedures and workflows are created for staff to ensure full quality customer service is provided for every call.

Even though great strides have been made over the years to standardize file formats and claims criteria, your system is different than the next payer. We can help educate providers on the nuances of your process that will help them complete claims more accurately, allowing for fewer denials on covered services.