Claims Administration

Looking to Outsource Claims Processing!!

Looking to Outsource Claims Processing!! The technicalities of any project are the backbone for its success. With proper understanding of technical specification, the chances of success increases drastically. The technical requirements differ from industry to industry. Since, we work in healthcare domain, we posses extra ordinary knowledge in our field of expertise. Our claims partner, [...]

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Reject Claims Analysis

On a regular basis, reject claims are monitored and classified into: Member Eligibility Issue Pharmacy claim processing error Clinical PA related B vs. D related Q L and Fast refill related Non Formulary Part D exclude High cost rejects PBM adjudication related

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Claims Audit

Claims Audit There are different types of Claims Audit found in market structure. Here, we are discussing only about Paid Claims analysis Audit process. Paid claims are analyzed on a regular basis at various levels given below: Utilizing Member Provider Pharmacy Chain (in network or out of network) Drug name Protected and Non Protected class [...]

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Steps in Claims Processing

Steps in Claims Processing The following are general steps used in claims processing by HealthTechnolgy.com: Identify Unbundling Upcoding And Miscoding Identify Duplicate Claims Compare Billed Services Against Pre-certified/Authorized Services Apply Network Discount To Network Provider Bills Apply UCR To Non-Network

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How is HealthTechnolgy.com different from others in Claims processing?

How is HealthTechnolgy.com different from others in Claims processing? HealthTechnolgy.com provides extraordinary services when it comes to Claims Processing. Some of value –addition is given below: Decreasing Administrative costs- Guaranteed Quality services Cost and performance guarantees Adequate geographic fit of provider and facility network and ability to enroll current network Claims processing and cost containment [...]

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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