Healthcare Payer Services
Data Marshall provides a full range of Claims Administrative services. Our services give you the highest payment accuracy with lowest operational cost. We practice matured Process Flows, State-of-the-Art Quality Assurance procedures. Our Claim Analytics are dome by trained professionals possessing deep domain knowledge. We possess a deep understanding of both the Payer and Provider domains which results in total control on overpayments.We use HIPAA complaint proprietary software applications for workflow management that has been built using robust technology tools. Couple of the process steps are handled after verifying data from several databases of payers resulting in increased Administrative Efficiency, Reduced Costs, Quick Settlement of claim payments and a true ROI.
Insurance Companies | Health plans | PPOs | TPAs | IPAs | HMOs
- Claims Administration
- Claims Data Entry
- Pre-adjudication Edits
- Claims Adjudication
- Claims re-pricing
- Travel Claims processing
- CDH Claims processing
- Encounter claims processing
- RX Invoice processing
- Benefit Plan Verification
- Provider Network Verification
- Deductibles [family and individual] Verification
- Verification of Pre-existing Conditions
- Provider Matching
- HSA Claims processing
- Physician Referral processing
- Enrolments Maintenance
- New group/employee
- Enrolments
- Scheduled Group renewals
- Letter communication
- Change plan preferences
- Add/change dependents
- Issue ID cards
- Terminations
- COBRA/Plan Reinstations
- Run-in plan inclusions
- Provider Database Management
- Provider Matching
- Provider updated Maintenance
- Facility updated Maintenance
- Network Management
- Claims re-pricing
- Out-of-network fee negotiation proposal processing
- Utilization Management
- PCP-Specialist referral processing
- Code Service & DX descriptions to CPT & ICD9
- Auto authorizations
- Forwards to Medical Directors review
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