HBMA 2010 Spring
Educationall Conference
Baltimore, Maryland
April 14-16, 2010
www.hbma.org

HFMA's 2010 Annual Conference
Nashville, Tennesse
Gaylord Opryland Resort
and ConventionCenter
June 20-23, 2010
www.hfma.org

HIMSS 2010 Annual Conference
Atlanta
Mar 1-4, 2010
www.hims.com

Radiology Summit 2010 The Broadmoor
Colorado Springs, Colorado
May 23-26, 2010 www.rbma.org

ASCO Annual Meeting  2010
Chicago, IL
June 4-8, 2010 www.asco.org

MGMA 2010  Annual Conference 
Ernest N. Memorial Convention Center New Orleans, Denver
Oct 24-27, 2010 www.mgma.com
 

 
 

Our Claims Adjudication Expertise includes working with Third-Party Administrators (TPAs) as well as Insurance Payers. We provide the following services:

 

Data Processing:

  •   New Member enrollment
  •   Updating Existing member Records (in case of change in policy and eligibility   terms)
  •   Data Capture & other mail room services
  •  Data capture from claim forms (UB92, HCFA 1500) both offline and     online
   
  •  Digitization and indexing of any kind of text into digital format
  • Premium Administration
  •  Application of periodic premium received to individual accounts
   
  •  End of day balancing of suspense accounts

Adjudication:

  •   Entitlement:
  •  Identification of the patient to determine if the individual is     covered by an active policy
  •   Duplicate Claims:
  •  Verifying to make sure if claim is duplicate
  •   Adjudicate validity of claim/Fraud detection:
  •  Compare HCFA 1500/UB 92 with Medical Remittance Notice and     adjudicate if submitted claim is valid
  •   Validate Claim Amount:
  •  Adjudicate claim amounts considering complex rule sets

 

 

  
 

 

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