Health Claim Administration Services

InfiniteBPO provides full range of claims processing and adjudication services. The payer team of Infinite smoothly facilitates matured process flows, state-of-the-art quality assurance procedures, reliable claims adjudication system and fully scalable solution adjudicating a high volume of claims. We have the technology and infrastructure to process high volume of claims on multiple payer systems.

InfiniteBPO has experience working on clients Data Mining Software and various claims processing softwares and understand its functionality in detail. We can help you in streamlining your processes and bring in operational efficiencies thus reducing costs. We use HIPAA complaint proprietary software application for workflow management which was built using robust technology tools.

Some of the process steps are handled after verifying data from several databases of payers resulting in increased administrative efficiency, reduced costs, quick settlement of claim payments and a true return on investment. We work with your existing systems and integrate our own propriety HIPAA compliant software or can provide a turnkey hosted solution to accomplish administration. We can administer all of your health plan activities or a few key functions.

• Health Claims Administration Services
  • Claims Indexing
  • Data Capture of HCFAs, UB-92s, ADA Dentals and SuperBills
• Pre-adjudication (Eligibility Checks, Provider Verification and Validation of CPTs/ICDs)
• Claims Processing / Adjudication
  • Electronic conversion of Paper Claims
  • Adjudication
  • Re-pricing
  • Settlement
  • Benefit Plan Verification
  • Provider Network Verification
  • Deductibles [family and individual] Verification
  • Verification of pre-existing Conditions
  • Subrogation
  • Stop Loss
• Cost Containment Services
  The health care industry is fraught with paperwork-related errors, especially when it comes to the filing of claims. These inherent errors while filing the claims might result in overpayments, when the claims are run through the Auto adjudication system. With rising healthcare costs being one of the greatest challenges, health payers and administrators need to contain these overpayments and improve claims payment accuracy.
  
  InfiniteBPO’s solution to the cost containment and claims payment accuracy issue is two-fold:
  • Identify & recover overpayments
  • Prevent overpayments