Payer Administrative Services
Are you swamped with claims that require adjudication? Are you lacking in-house efficiency to handle healthcare and medical claims adjudication without costing productivity? We, at Flatworld Solutions, hear your concerns and have just the solution to end your woes. Our medical claims adjudication services is designed to end fraudulent claims, limit cost overruns, and add more time to the day to focus on other core competencies.
Flatworld has the best team of medical claim examiners who know rulebook of the adjudication framework. With decades of experience in electronic and manual adjudication, we will adjudicate claims at record speeds. Our team will look for duplicates, errors, and other discrepancies that result in delay or denial of claims.
Healthcare Claims Adjudication Services
Healthcare Claims Adjudication Services We Offer
Flatworld is a leading healthcare BPO that has professionally handled medical claims processing outsourcing tasks. In just 18 years we have emerged as leaders in the segment because our team of medical claim examiners stays updated on the latest fraud practices used to exploit benefit. Our claims adjudication services include –
01
Determination of claims Value
02
Explanation of benefits
03
Investication of claims for Duplicates
04
Adjudication of Insurance Benefits
05
Data Extraction from Raw Claims
06
Checking Data Accuracy with Adjudicating Engine
07
Review of Diagnostic Code and patient Data
08
Evaluation of Healthcare service provider Details
09
In-depth Claims validation For fraud detection
10
Execution of Adjudication Claims
11
Claims Adjudicating Entitlement.
12
Computing Claims Amount
13
Coding, Bundling, And Review
14
Benefit- Based Determination Adjudication
Claim Types We Adjudicate
Flatworld Solutions is a world-class Healthcare BPO Service Provider where our professionals
Dental claims
Pends / Correspondence
Vision Forms
Wiscetianeous (Complex / Non-standard)
Remittance Processing Services
Pends / Correspondence
HCFA 1500 CMs 1600
vps21u804
Healthcare Claims Adjudication Process We Follow
Healthcare and medical claims adjudication is strenuous process that requires comprehensive knowledge of the cost containment measures to fight fraud. This task becomes complicated if you do not have a shilled team to adjudicate claims and precision. Outsourcing claims adjudication to Flatworld solves most of your concerns as we have people who are adept at manual ‘and electronic claims adjudication. Our claims adjudication process I as follows.
