HEALTH INSURANCE
CLAIM PROCESSING

The health insurance sector is becoming more competitive and new operating models are coming into the spotlight. In a dynamic business environment, medical insurance payers must sustain their efforts in marketing and enrolment, building customer retention, and striking a balance between their profitability, purpose and perceived value. When it comes to medical insurance claims processing, the challenges are multi-faceted - volume, accuracy, speed of processing, administrative costs and regulatory compliance all have a hand in improving customer satisfaction.

PHS is an expert Medical Insurance Claims Processing Outsourcing Services company. We empower health insurance payers to efficiently streamline the data processing aspect of the diverse insurance claim forms that are received from healthcare providers. Our healthcare BPO services enable payers to manage insurance claims in a more efficient and cost-effective manner.

For healthcare providers, we offer cost-effective and essential outsourcing services for medical claims related to charge entry, health claim transmission / submission, payment posting, accounts receivable follow-up and denial management, as part of our end-to-end medical billing outsourcing services.

• Medical Claim Data Entry
• Data Processing of all Medical Insurance Claim Forms, including UB-04, HCFA, CMS-1500, UB92, Dental Claims Forms
• Medical Claim Data Indexing / Extraction and Archiving
• Medical Claim Data Validation
• Provider and Member Data Maintenance and Cleansing
• Medical Claims Administration Support Services
• Medical Claim-related Finance (Billing, Accounts Payable Management etc.)