Analyze and Resolve with Expert Remediation

Top Claims Processing 
Services for You

Our claims processing services involve managing the entire lifecycle of insurance claims, from verifying patient coverage and accurately coding procedures to submitting claims, tracking their status, handling denials, and ensuring timely reimbursements. These services help healthcare providers reduce errors, comply with payer requirements, and improve cash flow by ensuring claims are processed efficiently and payments are received without delays.

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    Our Strategy of Medical Claim Processing

    Successful claims processing depends on fewer iterations, high throughput, and strong SLA compliance. Our process ensures efficiency and accuracy in claim management.
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    Claim Submission: The healthcare provider or insured individual submits the claim through the payer’s designated portal or system.

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    Claim Registration: Once received, the claim is logged into the system. If it meets initial criteria, it proceeds to the next phase without unnecessary delays.

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    Claim Validation: Patient and provider information is verified, including insurance coverage, medical necessity, CPT/ICD codes, and policy eligibility.

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    Claim Adjudication: The claim is reviewed by the payer to determine allowable charges, deductibles, and payment responsibilities.

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    Claim Settlement: Upon successful validation and adjudication, the claim is settled promptly, ensuring timely payments and reducing revenue cycle delays.

    claims processing services

    Key Features of Our
    Claims Processing Services

    Information Security

    As an ISO 27001 certified company, we ensure strict adherence to industry standards for information security, including compliance with GDPR policies.

    Experienced Professionals

    Our team is comprised of skilled professionals with solid management experience and global business expertise, ensuring high competency in all tasks.

    Cost-Effective Solutions

    We offer affordable solutions for all client needs, providing both standard and custom options to help you manage costs effectively.

    Advanced Infrastructure

    Our state-of-the-art call center technologies enhance productivity, streamline processes, and improve overall efficiency in service delivery.

    ISO Certification

    We comply with ISO 9001:2015 standards, ensuring adherence to quality practices and fulfilling the service-level agreements (SLAs) set with our clients.

    Superior Customer Service

    Our services focus on error-free processing, ensuring that claims are handled efficiently with minimal iterations, resulting in faster resolution times.

    Why Healthcare Chooses Our Claims Processing Services

    📈Increasing Approval Rates with Outsourcing: Outsourcing claims processing and billing services improves accuracy and speed through automation and skilled professionals.
    🤖Automation Benefits: We use AI and automation to speed up claims processing, improve accuracy, and provide valuable insights for healthcare BPO clients.
    🧑‍🔧Skilled Specialists: Our experienced claims processors ensure quick and accurate claims handling, resolving issues during adjudication effectively.

    Faster Reimbursement:

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    Reduction in Claim Denials

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    Improved Accuracy

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    Enhancing Patient Care
    With Claims Management

    As a top-tier provider of medical claims processing companies, our expert team at AffinityCore takes a proactive approach to streamline healthcare claims. By speeding up reimbursement timelines and enhancing cash flow, we help optimize your financial processes. With over 10+ years of experience in the U.S. healthcare industry, we have refined our methods to ensure accuracy and accelerate the payment process.

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