The HealthCare Industry Back Offfice

Medical Claims Processing

Distinguishing Features of our Solution
We currently process HCFA, UB & ADA forms daily by scanning/imaging these documents or accepting them from our clients via ftp. Each claim is manually entered using a double key & verify process. The output data is formatted into the required EDI format and transmitted to the client for adjudication.

  • 99.5+% accuracy
  • 72-24 hour turnaround time
  • System and interface flexibility (no significant upfront capital investment required)
  • A flexible process which fits our customers’ business rules
  • Double key and verify
  • Provider and eligibility database integration to improve auto-adjudication
  • Electronic archival and storage
  • Significant labor cost savings
  • ANSI 837 v5010 (or earlier), NSF 5.0 Ins titutional (or earlier), NSF 3.01 Professional (or earlier), ASCII, or
    any other dat a format requirement

Other Related Documents:

  • EOB
  • Eligibility requests
  • Superbill conversions
  • Repricing
  • Claims with attachments
  • Flex Forms
  • Enrollment Forms
  • Claim audit function