Infusing Efficiency into the Claims Operations of Health Plans
Payers in the healthcare industry face various challenges when it comes to claims adjudication. Key challenges include meeting customer, regulatory, and contractual turnaround times, effectively managing workflow and workload, attracting and retaining the appropriate skill set, reducing high costs per transaction, and implementing policy and procedure updates while launching new products and lines of business. These challenges can impact operational efficiency and hinder the delivery of timely and accurate claims processing.
Access Healthcare can help.
Claims Processing and Adjudication Services
At Access Healthcare, we offer a comprehensive suite of claims adjudication services designed to address these challenges and help payers optimize their claims management process. Our solution focuses on streamlining operations, improving accuracy, and reducing administrative costs. Leveraging our expertise, advanced technologies, and proven methodologies, we deliver efficient and accurate claims adjudication services that meet industry standards and exceed customer expectations.
End-to-End Claims Processing: Our seamless claims processing services cover the entire claims lifecycle, from receipt to payment. By leveraging our expertise and efficient processes, we ensure accurate and timely claims processing, reducing the burden on payers and improving the overall claims experience.
Claims Review and Validation: Our team of experts conducts thorough reviews of each claim, meticulously validating them to ensure compliance with the payer's healthcare policy. Through advanced technologies and stringent validation processes, we minimize errors and mitigate the risk of fraudulent claims, enhancing the integrity of the claims adjudication process.
Efficient Claims Management and Reporting: Our comprehensive claims management and reporting services provide real-time insights into the claims process. We offer robust reporting and analytics tools that enable payers to monitor performance, track claims, and make data-driven decisions for continuous improvement and optimization.
Value Proposition
At Access Healthcare, we deliver a strong value proposition for our payer claims adjudication services, ensuring that our clients experience efficient and accurate claims processing while achieving optimal outcomes. Here's what sets us apart:
We ensure claims are processed according to the Schedule of Benefits, adhering to industry-standard coding rules, and meeting or exceeding agreed-upon quality requirements.
Timely Processing. Our commitment to timely processing is evident as we strive to meet regulatory and/or group requirements for turnaround time.
Deep Health Plan Processing Experience: Our experienced staff possesses extensive expertise in processing claims across different lines of business and various third-party claims systems.
Increased Accuracy: Our focus on accuracy translates into 99% financial accuracy, minimizing errors and ensuring precise claims processing.
Timely Payment: With 99% of claims processed within 15 days, we prioritize timely payment, enhancing customer satisfaction and cash flow management.
Industry Best-in-Class Service Levels: Our commitment to excellence goes beyond expectations, as we consistently meet and exceed industry service level benchmarks, elevating the quality of claims adjudication.
Enhanced Provider Satisfaction: Through efficient and accurate claims processing, we contribute to increased provider satisfaction, building strong relationships and fostering collaboration.
Reduced Operating Costs: Our streamlined processes and optimized workflows lead to decreased operating costs, improving profitability for our clients.
Increased Operating Efficiencies: We bring increased efficiencies to our client's operations, including higher throughput, reduced implementation and ramp-up time, fewer customer service calls, and minimized rework.
Ready to optimize your claims adjudication process and enhance operational efficiency?
Partner with Access Healthcare for payer claims adjudication services that deliver value, efficiency, and member/provider satisfaction. Please fill out the form below to get in touch with our experts. Discover how Access Healthcare's claims adjudication services can streamline your processes, improve accuracy, reduce costs, and increase provider satisfaction. Let us be your trusted partner in delivering efficient and accurate claims processing for better patient outcomes.