FAQs on Outsourcing Claims Adjudication Services

1. What Does Adjudication Mean in Billing?

By outsourcing claim adjudication services, your claim for settlement of benefits will be evaluated by an adjudicator. He or she decides whether the claim justifies the coverage prescribed by the insurer.

2. Tell Us More About Your Claims Adjudication Services?

Our claims adjudication follows a scrip that is proven to be better at establishing the claim eligibility and the assured sum. We track data to the source and audit the finding to ensure zero lapses.

3. How Can I Outsource My Project Requirements?

The first step is to talk to our experts to understand what services are best suited for your needs. The next step is to pick a service package that is the right fit for your budget. There is room for negotiation if your project can be scaled in volume. Finalize the contract and sit back while we do the rest.

4. What Other Services Do You Offer?

The services we offer under claims adjudication are dental claims adjudication and remittance processing . These are highly coveted services that streamline the burden at your back office. We also offer other services like medical transcription , medical billing & coding , RCM , EMR , Teleradiology , medical animation , and more.

5. What Are The Five Steps In the Adjudication Process?

The five steps in healthcare claims adjudication services involve -

• Preliminary review
• Automatic review
• Manual review
• Payment determination
• Payment closure

6. How Do I Follow Up On A Medical Claim?

When you outsource claims adjudication services, it is only through frequent follow-ups that claims get processed efficiently. It's important to check the claim status and document responses as part of the workflow prescribed for claims adjudication services in the USA.

7. What Fees Do You Charge? Do You Provide Flexible Payment Options?

By providing claims adjudication outsourcing services, Flatworld has made sure to keep the rates flexible and within reach of customers. That said, our pricing range from $4.5 to $60 per read and if you prefer an FTE, the rates float around $1280 to $1600 a month. That roughly translates to 40% savings.

8. How Do Electronic Claims Work?

Claims adjudication service companies are expected to submit claims electronically to fast track the claim process. In this process, CPT codes are matched with the ICD-9-CM and ICD-19-CM based on the care provided and submitted in ANSI 837 format. The purpose is the eliminate errors and ensure HIPAA compliance.

9. How Long Does It Take to Get Started?

Flatworld stands out from all claims adjudication services companies because of our claims adjudication services kick-off within a few days or weeks as per the client's readiness. All service facets are customizable to the last bit. Within weeks of commencing the service, the client should be capable of seeing benefits.

10. What Makes Flatworld Solutions Different from Other Clearinghouses?

In the last 20 years, we have acquired experience in all aspects of medical claims adjudication services, and getting HIPAA certified for the claims adjudication process is another feather in the hat moment for us. Bet it pricing or quality, we have excelled as a top medical claims adjudication services provider.

11. Can I Contact Flatworld Solutions Through Phone Or Email?

Response from Flatworld is lightning quick through phone, email, and webchat. We are reachable 24/7 to address any concerns affecting the project and will strive to deliver a unique experience through each interaction. You can reach us through any preferred means. Be it a phone call, email, or webchat. If you prefer to contact us online, make sure to let us know know your needs by filling a simple form.

Outsource Medical Adjudication Services to Flatworld Solutions

Flatworld Solutions has been a primary medical adjudication partner for top-tier healthcare institutions and even small practices because in the last 20 years we've revived our knowledge and expertise in various aspects of medical adjudication services. We are well-versed in policy fine print and adjudication framework to carry out the process as per the HIPAA standards. Our agile method and sophistication come together to help you align with the best adjudication practices. If you have queries regarding other services we offer as part of claims adjudication , we can help you out.

Contact Flatworld Solutions today and discuss your requirement with our experts to get a quick quote that suits your need.