With our extensive experience, we at Mbsap dedicate ourselves to not only making this an error-free and smooth process but ensuring that all your claims are settled on time. Our expert teams are here to resolve all your queries and explain all the details in an understandable manner thus keeping you informed about the entire process. Mbsap medical claims and encounter processing services has never been simpler.


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    Medical Claims and Encounter Processing Services We Offer

    Over the last 22 years, Mbsap, which is undoubtedly the best medical claims and encounter processing service provider in India, smoothly and efficiently handles medical claims and encounter processing. Our medical claims and encounter processing services include –

    Data Entry for Medical Claims and Encounter Processing

    Firstly, we provide you with the list of documents required by your insurance company to begin with the claims process. Here we acquire all patient information, consulting physician details, and all code sets which are then meticulously entered into our billing software. All data is systematically compiled and submitted electronically. A hard copy of the medical/encounter claims can be obtained upon request.

    Medical Claims Authentication

    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 in accordance with 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. Kindly note that any falsified information leads to the cancellation of the claim process.

    Medical Claims Data Processing

    All information is cross-checked before processing. We process all documentation in accordance with the protocol of the insurance company. Claims/encounters that pass the editing process are then translated to HIPAA-compliant ANSI format. This is followed by obtaining your signature on the final report before sending it across to the insurance company.

    Review of Medical Claims and Encounter Processing

    The Encounter Data Records (EDRs) and Chart Review Records (CRRs) should comply with the submission policies. All accepted and rejected claims are closely reviewed by us. We are equipped with the complete knowledge of Medicare and Medicaid payment regulations as well.

    Medical Claims and Encounter Processing Resubmissions

    Claims that are not compliant are sent back for the necessary corrections. In the case of claims rejection, we make the resubmissions as requested. In cases of claim denials (these cases cannot be resubmitted for assessment), we review the cause of refusal and accordingly make an appeal requesting reconsideration. Once approved, we put in a fresh application.

    Medical Claims Administrative Support

    Our team has strong verbal and written communication skills. We provide complete assistance for claim approval. We offer help with regards to any missing data. We contact the competent authorities to obtain duplicate copies of any bills or prescriptions in case of any missing information.

    Medical Claims/Encounters Data Indexing

    It includes collating and storing data such as the patient’s demographic, EOBs, health insurance information, and treatment information in a systematic matter allowing for easy retrieval later. This helps is quick assessments in case of requirement of any healthcare documents in the future.

    Medical Claims Maintenance

    Our staff pays attention to detail. Every submission is kept confidential and maintained in an orderly manner. We can be approached at any stage, without any hesitation, for a duplicate copy of the medical and or/encounter claim.

    Explanation of Benefits (EOBs)

    We intimate you of the medical expense covered by the health care/insurance provider as what part of the expense if need be, is your responsibility. We give complete details on the deductible or a co-pay that needs to be taken care of.

    Accounting Support for Medical Claims

    Our staff cross-checks all the financial details reported to us by the insurance company. We ensure that you have the advantage of acquiring maximum pay-out from your health care provider.

    Online Tracking of Claims Application

    You will be notified at every stage of the progress of your application. This can be assessed by you at any moment.

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