Medical Insurance Claims Processing Services
Are you struggling to claim the top spot in medical insurance claims processing? Do you face patient's ire on the slow rate of claims processing? If you are in the middle of a storm, then we can hoist you from the ocean of troubles that accompany health insurance claim process. To begin with, we will address the typical challenges in medical insurance processing such as accuracy, volume, regulatory compliance, the rate of processing, and administrative costs.
Our strategy is to ensure that your practice is uninterrupted while we resolve challenges one at a time. We collect insurance claim forms from healthcare practitioners and check if the fields are completed and accurate. Through strict evaluation, we mitigate claims denial due to negligent data entry or lapse in the documentation.
What is Medical Insurance Claims Processing?
Expediently processing claims require documents with accurate data that aligns with industry standards and technical protocol so that the healthcare back-office support services are less cumbersome for payers and medical practices. Medical billing specialists often rely on specialized billing software rather than manual methods, to prepare medical insurance claim forms. Since speculated data can undermine a smooth payment cycle, the software will ensure that the reported patient information is accurate and fact-based. Some medical billing software will go a step further by enabling submission of records to insurers in HIPAA compliant format for standardization of electronic information.
Since many healthcare providers and insurance companies opt electronic claims processing, the software has become faster and efficient by considerably limiting operational costs. At present, the cost of processing stands at nearly $3 per claim. However, since a small portion of the claims process still involves paperwork, medical billing and coding companies are expected to be proficient in manual and electronic medical insurance claims processing.
Medical Insurance Claims Processing Services We Offer
Flatworld Solutions is a medical claims processing services provider that is heavily invested in claim processing in healthcare. We follow the safest HIPAA compliant practices that will help you get paid faster with minimal risk of denial. Our goal is to ensure that your claim forms adhere to regulatory compliances without documentation errors. The solutions offered as part of medical insurance claims processing services are as follows -
Data entry in medical insurance claims involving CPT and ICD codes along with modifiers and details of referring physician
Processing medical insurance claims forms such as HCFA, UB-04, UB92, CMS-1500, and dental claims
Investigation of denied claims and resubmission
Drafting explanation of benefits
Indexing, archiving, and extraction of medical claims data
Validation of medical claims data
Cleansing and maintenance of EHR and EMR to ensure proper documentation of member data
Administration support for medical claims
Accounting and finance BPO services in medical claims
Medical Insurance Claims Process We Follow
At Flatworld Solutions, we focus on system design and process flow of the software to process claims with due diligence and agility. Medical insurance claims processing outsourcing is a practical and cost-effective way to speed up the reimbursements without running into compliance or accuracy issues. The health insurance claim process we follow is simple and transparent. Here is a snapshot of how we do it -
Notifying the Insurance Company
Reimbursement can be initiated within 30 days of discharge by furnishing reimbursement claims form to the insurer
Submission of Original Documents
We will submit the original copies of medical bills, hospital bills, reports, and the claim forms. The reports should explicitly mention accurate hospitalization details
Submission of Discharge Summary and Doctor Certificate
We will collect the patient discharge summary and doctor certificate for submitting to the insurer. We will also furnish the prescription advised during hospitalization
Submission of Follow up summary and Post Hospitalization bills
The original follow-up prescription from the doctor along with post-hospitalization bills are submitted to insurers within 60 days from the date of discharge
Documentation of Submissions in EMR and EHR
We will retain a digitized copy of the furnished documents on the Cloud for record-keeping and future reference if the claim is denied by insurers
Other Medical Claims Support Services
We will handle account receivables, payment posting, accounts reconciliation, and much more on a need basis
Why Choose FWS for Medical Insurance Claims Processing Services?
When you outsource medical claim processing to FWS we will scrutinize the completeness of documents to understand if enough supporting data can be furnished to secure reimbursement against medical and hospitalization invoices. We will also evaluate the accuracy of the form fill-ups to ensure that the reported information is accurate with evidence linking the paper trail. Our crisp workflow is one of the top reasons why many clients consider FWS time and again. Here are more reasons why we are still the first choice -
Certified Medical Insurance Claims Processing Company
With 20 years of solid industry presence, we have emerged as a top insurance claims processing company in India thanks to our team whose unwavering commitment has led to timely revenue generation for practices. Today, we take pride in becoming ISO 9001:2015 certified as well as HIPAA compliant in healthcare billing niche.
Data Security
We understand the importance of confidentiality in healthcare billing because it involves a high volume of patient data which includes personal and financial information. This data has a certain monetary value attached to it that can give an unfair advantage to spam marketers and wrongdoers. We have you covered from this risk by allowing only signatories of a non-disclosure agreement to handle medical insurance claims processing. We are ISO/IEC 27001:2022 certified for following secure data management practices
High Accuracy and Quality Service
Quality is a point of concern for many and we have heard you! Be it documentation, filling forms, or submitting claims we meticulously examine the accuracy and completeness as a proactive measure to prevent the medical insurance claims process from going down the drain. After all, reworking denied claim is time, resource, and cost intensive.
Short Turnaround
With a quick turnaround time, you will never have to wait more than 2 to 3 weeks to get reimbursed. This is because we work with agility to take your documents and claim forms to the concerned operator at the insurer's end. We send files electronically in a format that is approved by the HIPAA transaction and Code Set Rule (TCS)
Scalability
We can offer services that can be customized with respect to the volume, and the rate of processing. Depending on your needs we can scale up or down so that you can focus on the practice with maximum versatility.
Pocket-friendly Pricing
When you are looking for reasons to outsource medical insurance claims processing cost is one among them and we know it well. Hence, we present medical insurance claims processing services in a customizable way that would let you choose what is best for your need. Our cost-friendly pricing can help you take advantage of our services without stretching your budget
Single-point Contact
We can end your struggle to find a concerned person to communicate your requirement by appointing a dedicated professional who will stay in touch from inception to completion of the service. Our subject matter experts are nested in a contact center at your local time zone to provide the fastest support without stretching the call time.
Experienced and Certified Medical Coding & Billing Experts
Our 250+ certified medical and coding specialists can invigorate your revenue cycle management by working from the ground up. We will analyze your needs and work a solution that is best fit to avoid claims denial. The team's awareness of the insurance laws, coding conventions, and regulatory compliances can be of specific advantage to your practice as we will do the heavy lifting on your behalf.
Modern Infrastructure
We are housed with the latest technology, hardware, and physical infrastructure that is 100% consistent with the current trends. With an updated infrastructure we are poised to handle any challenges that we confront with confidence. Our infrastructure is also the reason why we fast-track reimbursements and keep our clients happy.
Secure Data Sharing
With the advent of more digitized and simplified data sharing facility, the risk of data loss due to external threat is ever-present. We secure your data security concerns by providing a secure FTP and VPN that can be leveraged to send confidential files.
24/7 Support
You can connect with us by phone call, email, or ping us via web chat. With flexible options, you can engage with our support agent on a 24X7X365 basis without time zone restrictions. Our high-availability contact center support will inspire confidence and keep you close to us.
Client Success Stories
Flatworld Provided Insurance Eligibility and Verification Services to a Birth Control Telemedicine Provider
FWS verified the eligibility of pharmacy and medical insurance applicants for a US-based telemedicine provider.
Read More
FWS Provided Healthcare Accounts Receivable Service to a US client
FWS sped up the collection by streamlining the billing for a US client. The process was completed in quick TAT with minimum spending.
Read More
Outsource Medical Insurance Claims Processing Services to FWS - Leader in Medical Billing & Coding
Medical billing and coding services are sought after by practitioners, hospitals, clinics, and other healthcare facilities that are seeing more patient encounters with a fewer resource to handle resource-intensive process such as medical insurance claims processing. With a knowledgeable team of expert billers, we focus on bridging your revenue cycle needs with precision. You can utilize our services to increase your revenue without worrying about claims rejection due to partial or erroneous documentation. We also offer a gamut of other services such as medical claims processing, accounts receivable follow-ups, denial analysis, and more.
Reach us now and get a customized quote for medical insurance claims processing services in 24-48 hours.
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Whom do we serve
Our Customers
Key Differentiators
AHIMA Healthcare Convention 2016
USA
Flatworld Solutions
116 Village Blvd, Suite 200, Princeton, NJ 08540
PHILIPPINES
Aeon Towers, J.P. Laurel Avenue, Bajada, Davao 8000
KSS Building, Buhangin Road Cor Olive Street, Davao City 8000