HealthCare Payer Services – PAS, CMS, AAS and RPS

HealthCare Payer Services – PAS, CMS, AAS and RPS

Platform & Administration Services – PAS

  • Ancillary Benefits Administration (AD&D)
  • Claims Adjudication
  • Claims Runoff Administration
  • Claims Services
  • Coordination of Benefits (COB)
  • Eligibility
  • Flex Plan Administration
  • Identification Cards
  • Issue employee materials
  • Member Education/Communication
  • Stop-Loss administration
  • Summary Plan Descriptions (SPD)

Care & Medical Management Services – CMS

  • Case Management
  • Concurrent Review
  • Customer Service/Call Center
  • Disease Management
  • Pre-Admission Review
  • Pre-certification (pre-cert” or Pre-Authorization) – PA
  • Retrospective Review

Analytics and Actuarial Services – AAS

  • Claims Auditing
  • Claims History reports
  • Claims Investigation
  • Claims Re-pricing
  • Reporting
  • Reporting to the stop-loss carrier
  • Risk Management

Revenue and Payroll Services – RPS

  • Accounting Support and Reconciliation
  • Billing/Premium Billing
  • Capitation Payment Management and Processing
  • Claims Subrogation
  • Recovery/Collections Management
  • Reporting for claim funding

For HealthCare Services – PAS, CMS, AAS, RPS, call Manish Jaiswal @ 646.644.3049

 

 

 

 

 

 

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425 Washington Blvd., Jersey City,
New Jersey 07302, USA

Phone: +1 201.258.4704 / 201.258.4704
Fax: +1 201.604.3480