Claims Management
Streamline your claims processing with our advanced automation system that ensures accuracy and faster reimbursement.
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Claims Management
Our Claims Management service is designed to help practices maximize revenue and reduce time spent on billing tasks. With built-in automation and expert oversight, we reduce submission time by up to 75% and maintain a 98%+ clean claim rate, minimizing rejections, and accelerating payment.
No more manual errors. No more backlogs. Just clean, compliant claims submitted right the first time.
What We Offer
Key Benefits
Faster Submissions
Reduce turnaround time by 75% with automated claim workflows.
Cleaner Claims
98%+ clean claim rate through smart error detection + expert review.
Faster Reimbursements
Eliminate delays and get paid quicker without chasing payers.
Our Claims Management Process
Our claims management process is built for speed and accuracy. From initial claim creation to tracking reimbursements, we ensure every step is optimized to reduce errors and accelerate payments.
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Claim Preparation
Collect and verify all required patient and coding data.
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Automated Submission
Submit clean claims electronically to payers with built-in validation.
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Tracking & Monitoring
Continuously monitor claim status for delays or rejections.
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Reimbursement Posting
Post payments and reconcile with financial systems for full transparency.
Our Claims Management Process
Our claims management process is built for speed and accuracy. From initial claim creation to tracking reimbursements, we ensure every step is optimized to reduce errors and accelerate payments.
Encounter & Charge Capture
Collect patient encounter data from the EHR, intake forms, or provider notes
Verify date of service, rendering provider, location, and service type
Flag missing or inconsistent charge entries for correction
Foundation of a claim starts with accurate charge capture.
Coding Review & Validation
Apply correct CPT, ICD-10, and HCPCS codes
Add appropriate modifiers based on payer policy and procedure documentation
Validate medical necessity based on documentation
Check for NCCI edits, bundling, and unbundling risks
Proper coding = maximum allowable reimbursement.
Payer-Specific Claim Configuration
Confirm payer ID, billing taxonomy, provider credentialing status
Populate required claim fields based on each payer’s format
Ensure claim aligns with payer-specific billing rules (e.g., POS codes, claim type)
Every payer has quirks. We prepare for them upfront.
Insurance & Eligibility Cross-Check
Reconfirm insurance coverage and policy effective dates before submission
Validate patient demographics, plan details, and coverage type
Identify and flag COB (coordination of benefits) issues when applicable
Coverage errors are one of the top causes of rejected claims.
Claim Scrubbing & Pre-Submission Audit
Run every claim through automated scrubbers for format, code, and logic errors
Manually review claims flagged by scrubbers or with high denial risk
Check for duplicates, date inconsistencies, missing NPIs, or invalid combinations
Our goal: a 98%+ clean claim rate. No rework required.
Electronic Claim Submission
Batch claims and submit via clearinghouse or direct-to-payer connection
Confirm transmission success with acknowledgment reports
Log payer tracking IDs for downstream adjudication follow-up
Every clean claim is tracked from send to status.
Practice Owner
