Claims Management Services
Streamline Your Claims Process with Univalyx's Expert Services
Our experienced team handles all aspects of claims management, ensuring accurate and timely reimbursement.
Univalyx provides a full spectrum of services in claims management, aiming to simplify and optimize your operations, maximize reimbursements, and ensure compliance. We offer comprehensive claims management solutions for healthcare providers and payers of various sizes. Our team of proficient professionals handles every aspect, covering plan administration, member enrollment, and claims entry to streamline and enhance the entire process.
Here's how we can help:
- Create and manage benefit categories and IDs.
- Load fee schedules and modifiers for accurate claims processing.
- Develop contract classification codes and templates.
- Set up contracts for both par and non-par providers.
- Manage fee schedules and provider types.
- Scrub and load member demographics accurately.
- Verify data on government portals.
- Process daily enrollment and disenrollment files.
- Handle both paper and electronic claims efficiently.
- Correct inaccurately paid claims and process refunds.
- Address call center tickets and claims issues.
- Utilize expert knowledge of HCFA 1500 and UB 92 forms..
- Optimize claims processing to prevent leakage and ensure compliance.
- Manage the Ingenix Claims Processing System and other third-party systems.
- Receive and process referral requests from various channels (fax, email, phone).
- Load referrals and authorizations into designated software for tracking
- Verify provider credentials through CAQH and follow up for missing documents.
- Ensure the highest level of accuracy and compliance.
- Utilize third-party portals for accurate pricing based on Medicare allowable limits.
- Promote coding consistency and data quality.
- Minimize compliance risks and address NCD/LCD edits.
- Perform background checks through DMV, DOI, and OIG portals.
- Protect your organization and ensure agent compliance.
Benefits & Results:
Increased revenue
Minimize claim denials and ensure timely reimbursements.
Enhanced compliance
Stay compliant with complex regulations and coding standards.
Better patient care
:Focus on patient care instead of administrative tasks.
Improved efficiency
Streamline claims processing and reduce administrative burden.
Reduced costs
Control costs through accurate coding and efficient workflows.