Digital Services & Health Insurance - smartData TOP
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AI and IoT base medical apps and healthcare app development

Digital Services & Health Insurance

With prime focus on patient empowerment, engagement and personalized patient journey, our software applications are serving all the key players in healthcare including regulatory bodies, insurance providers, pharmaceuticals, employers and caregivers. smartData is leveraging digital health technologies to improve access to healthcare services, reduce costs, improve quality of care and enhance the efficiency of healthcare systems.

smartData is assisting Health insurance companies in designing and developing creative and innovative health improvement programs to reduce costs. On similar grounds, our healthcare developers have assisted in designing solutions for employers to engage their employees in lifestyle modifications to encourage a happier and healthier workforce.

Healthcare delivery through Digital health platform at smartData has helped our healthcare clients in streamlining their workflows by providing business intelligence tools to get better insights on population data, revenue cycle management, homecare for elderly population, nursing homecare software, healthcare payment auditing and learning platforms for self-evaluation with enhanced patient care.

A high-level glimpse of our digital health services that cater to

  • Healthcare marketplace for staffing and Recruiting
  • Clinical research and trials
  • Pharmacy medication therapy management
  • Homecare services with electronic visit verification of caregiver
  • Caregiver mobile apps
  • Nursing Home management software with point of care mobile apps
  • Nursing home quality compliance
  • Healthcare analytics and reporting
  • Medico-legal
  • Healthcare training and education
  • Payment auditing for Medicare/Medicaid overpayments
  • HIPAA compliant healthcare messaging platform

Healthcare insurance can be complicated. Understanding the policies is important for consumers. consumers i.e. patients can have employer-sponsored healthcare insurance or Government i.e. regulatory bodies OR direct insurance from payers. Medical billing insurance claims process gets started when a healthcare service provider gives medical care to a patient and sends a bill of provided services to a healthcare insurance company. The payer then evaluates the claim based on several factors, determining which, if any, services it will reimburse. Our healthcare insurance developers have strong expertise in developing, enhancing and maintaining HIPAA compliant solutions on insurance background.

A few listed as below:

  • SaaS-based healthcare insurance portal for ambulatory surgical centers, office-based surgical practices and hospital anesthesia departments
  • 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.
  • Payment postings and discrepancy in payments if necessary
  • Identify and bill secondary or tertiary insurances
  • Financial Reports 
  • 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

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