A few features of our solutions:
  • SaaS-based healthcare insurance portal for ambulatory surgical centers, office-based surgical practices, and hospital anesthesia departments

  • Payor services and medical claim processing

  • Referrals and pre-authorizations as required for procedures using EDI 270/271

  • Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.

  • Generating charges/claims/patient bills

  • Preparing and transmitting claims including electronic and paper claim processing using EDI 835/837.

  • Utilization of CPT/ICD 10/11 and medical billing codes

  • Payment postings and discrepancy in payments if necessary

  • Identify and billing of secondary or tertiary insurances

  • Financial Reports

  • Reviews and ratings

  • Resolve discrepancies, denials, appeals and collections in health insurance

  • Initial validation through pre auditing to improve HEDIS rating

  • The platform for HEDIS dashboard for real-time analytics

Estimate Project