Claims processing is a big part of the services we provide to the physician network.
Our services include standard formatting for health care administration and submitting claims, including the CMS1500, UB04 and pharmacy forms. Additional claims processing services include auto adjudication, repricing and uppricing.
Our software is also fully integrated with Optum’s Claims Edit System and is in compliance with NCCI and CMS guidelines.
We believe in working together with our partners to provide the highest and most efficient level of Business Process Outsourcing for Specialty Provider Networks, Health Plans and other Managed Care Organizations.