MBSAP EOB PROCESSING SERVICES
The processing of EOBs is, without a doubt, a lengthy, time consuming one especially when dealt with manually. This inevitably ends up being overwhelming for your staff whose efforts could be made use of for other urgent matters. We provide EOB processing help to individuals, physicians, dentists, healthcare centers, and private hospitals. With our successfully developed workflow, opting for our EOB processing services will entitle you to faster claim approvals, far fewer rejections and/ or denials, and fewer payments-in-parts.
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EOB Processing Services We Offer
Over the last 2 years, executives at Mbsap articulately handle the overall EOB processing via an impressively designed system. Being a top EOB processing service providing company, we offer Explanation of Benefits (EOBs), a statement that provides clearly by describing the cost of medical or dental benefits as per your chosen medical or dental health insurance plan respectively. The services that we are reputed for are as mentioned below –
Evaluation of EOBs
Once the claim is filed the EOB is sent across with particulars such as –
- The complete patient, doctor and hospital details
- Medical/ dental service procedures performed
- Cost of the performed procedures and/ or services received
- The amount covered by the insurance plan
- Payment to be made by you
- Co-payments in cahoots with patients
- Details of deductibles
- The amount that may have been utilized from spending accounts such as Health Reimbursement Account (HRA)
We conduct stringent checks to ensure that all documents, bills, and invoices handed over to us are valid. Any medical claims and encounters submitted, if not per the billing system, will be returned to you with a complete explanation of the missing or incomplete information. We identify the circumstances that could delay the claim process and help you with tackling the same.
EOB Fraud Detection
Our thorough assessment helps detect any incorrect details mentioned in the EOB communicated. We ascertain that you do not lose out or end up paying in case of any unlisted service mentioned and/ or any discrepancies in the EOB.
Eligibility and Benefit Verification
We thoroughly cross-check if your claim can provide you with more advantages than you are led to believe by the insurance company. The EOB statement is verified by us and only after we are satisfied by the amount to be remitted do we go ahead with the EOB processing.
EOB Processing Software
The EOB processing software is the latest of its kind. Every bill input is precise and all documentation on a claim can be examined at a glance making the processing much simpler. Being a top provider of EOB processing services in India, we maintain a record of who accessed and/ or edited any EOB data to ensure that complete confidentiality is maintained.
Explanation of Benefits Management System
With our digitalized data storage and retrieval system, EOBs are scanned, uploaded, and securely stored in our database. Our online filing helps save a lot of space that would otherwise be taken up by tons of paperwork. This eliminates the need for hoarding hardcopies and making sure that they are not misplaced or tampered with. We also provide complete assistance with secondary insurances with primary EOBs.
We can help amplify the insurance benefits via prior pre-authorization. Based on the EOBs that you received you can prepare yourself for the reimbursements you will compensate with or come up with the procedure that could grant you a better pay-out. This is where we step in and help you out with pre-authorization. Thus there will be no surprises at the time of receipt of the claim amount. Also, the chances of denials are reduced with the sending across of pre-authorizations.
This helps us optimize claim management as well as to conduct predictive analyses to overcome potential denials. One of the biggest reasons for claims denial is due to errors while processing. You require highly-skilled and efficient staff to notice any errors in EOB and if your employee misses it then there are high chances of losing out on the claim. We are adept with the analytics that helps us gauge the claim payouts. With our extensive experience, in dealing with various insurance providers, we can recognize how much money can be recovered from a certain policy although the insurers may state otherwise.
Claim Remittance Details
We cross-check to see that the compensations are made according to the EOB received. We immediately notify the insurance company of any payouts that have not been calculated, denied, or do not match with the sum that you were assured. This ensures that you get your promised dues. After insurance payments are revealed, if need be, the EOB processing software can then be used to create any secondary claims for submission.
Benefits of our processing services also include help with specifics such as procedure of filing an appeal in your state of residence, tracking EOBs via aging reports, etc. With our searchable repository, all documents can be tracked, viewed, and modified according to the insurer’s terms and conditions.
Online Claim Status Tracking
You can check the progress of your application via the link provided to our online tracking system. If we detect any hurdles during the claims process they are immediately verified and corrected by us.