Medical Claim Processing

Medical Insurance Claim Management

We submit EDI or paper claims with no claim submission lag days and also check and resolve any rejection received under the pre-adjudication process of clearing house or payer. We at Apricus, audit the charges and submit both Paper and EDI claims based on the payer criteria of accepting the claims. When the claim is submitted then we don’t leave the tracking of the claim until it is paid by the payer. Each claim we have submitted is tracked and analyzed again within 24 hours based on the acknowledgment received from either payer or clearing house. Our team of experienced people at Apricus understands most of the rejection reasons and takes the appropriate actions like correction and resubmission or payer calling for that particular claim thus making that claim attended and worked back in 24 Hours. We will always target to achieve ‘No Unattended Claims’ for any specialty which means No hold revenue for our clients.

We aim to achieve a 95% Clean Claim Ratio for our clients by going in a customized manner, case to case and Individual to an individual for all the claims and charges that we submit. We always assure that we have correct billing, constant revenue flow into the practice, and No cost to our clients for repetitive claims processing.

FAQ’s On Insurance Claim Processing

Our health insurance claims processing services check on the inconsistencies and missing information. It would help in rectifying the errors, before filing the claim. It would help in faster processing and easier claims.

We handle healthcare claims processing electronically and paper format too.

Yes, we do. If we believe the non-payment is due to legitimate reasons (such as lack of coverage or deductible, capitation), then we would not proceed with denial management process. If it is any other reason, then we would proceed with denial management in healthcare.

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