Outsourcing can Assure you of Fast & Accurate Claims

Posted on November 30, 2012

Is your insurance organization suffering from improper claims adjudication processes that are resulting in erroneous or fraudulent claims? Or maybe you have improperly processed genuine claims and now have to face litigations.  The best way for your organization to get out of such a tight spot is to outsource claims adjudication to India.

Tons of impending unprocessed claims can leave you and your staff overloaded, tired and stressed. Instead of struggling with your claims in-house, you can opt for outsourcing. A professional service provider in India can seamlessly handle your entire process in a streamlined manner and complete your claims quickly and accurately. With outsourcing, you can get rid of operational bottlenecks and administrative overheads. At the same time, you can also make huge cost savings.

Types of claims adjudications that can be outsourced

Skilled Indian outsourcing service providers like Flatworld Solutions, can efficiently handle any type of claims adjudication, such as:

  • Correspondence or Pends
  • UB04 / UB92
  • Dental claims
  • EFPs (Enrollment Forms Processing)
  • Vision forms
  • CMS1500 / HCFA1500
  • Miscellaneous claims (non-standard or complex )

The claims adjudication process followed in India

Indian healthcare service providers like Flatworld Solutions, ensure that maximum accuracy and minimum speed is maintained by following a structured process and a strict review. When you outsource your claims to India, it will go through the following seven steps:

  1. Eligibility identification
  2. Verification of duplicate or fraudulent claims
  3. Diagnosis review (EMR/ EHR), coding and bundling
  4. In-depth analysis of the hospital
  5. Benefit determination adjudication
  6. Rules-based edits
  7. Recommendations

5 benefits you can leverage by outsourcing claims adjudication to India

Outsourcing claims adjudication services to an Indian healthcare service provider, can give your organization access to manifold benefits like:

1. Huge cost savings: Save a whopping 30 -40% of the cost that you would need to spend on resources and in-house employees.

2. Focus on patient care & other core activities: With tiresome claims adjudication work out of your hands, your organization can focus on core competencies.

3. Better customer service: With a professional Indian service provider handling your claims adjudications needs, you will quickly see an increase in brand loyalty and customer services

4. Improved accuracy and lower turnaround time: Outsourcing claims adjudication services to India, will drastically reduce the time it takes to review and settle claims. You will also be able to see a marked difference in the accuracy of your claims.

5. Save on overhead and administration costs: By outsourcing, your company need not spend a huge sum of money on running an in-house claims adjudication department.

Outsource claims adjudication to India today and give your insurance organization the competitive edge it deserves.

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