Mailroom & Scanning

Complete mailroom & scanning capabilities

Web-based image repository & lookup for authorization

Medical bill (HCFA 1500, UB 92) administration services

Medical bill data entry, OCR or double blind key

Repricing to state-mandated fee schedules and/or network discounts

EDI File Generation

Electronic download of medical bill information

Creation of indexed file

Formats supported include ANSI 837, NSF, EMC, ECSIF, XML

Medical management

Nurse triage paired with FROI

Medical bill review

Utilization management

Utilization review

Medical management analysis

Case management

Account management services

Account setup

Proposal generation

Billing and receivables

Account reconciliation

Customer service administration

Insured inquiry resolution

Provider inquiry resolution

Insured outreach

Telephone satisfaction surveys

Value-added professional services

Network development and management

Provider performance analysis

Provider credentialing

Provider setup and maintenance

Provider database management and directory maintenance

Accounting and financial reporting

Revenue reporting and analysis

Medical cost reporting and analysis

Reinsurance reporting

Specialty services

Dental bill administration

Pharmacy bill administration