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| Services : BPO : Healthcare Payers |
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Our Healthcare Payer BPO services include: |
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Claims Indexing |
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Data Capture of HCFA's, UB-92's, ADA Dentals and SuperBills |
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Pre-adjudication (Eligibility Checks, Provider Verification and Validation of CPTs/ICDs) |
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Claims Repricing |
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Adjudication |
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Benefit Plan verification |
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Provider Network Verification |
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Deductibles [Family and Individual] Verification |
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Co-insurance and Co-pay verification |
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Verification of Pre-existing conditions |
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Subrogation |
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Stop Loss |
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| GeBBS offers TPA's, health plans and other healthcare payers, data capture services using a combination of KFI (Key From Image) and OCR (Optical Character Recognition). We believe that our BPO claims processing model, utilizing technology and manual resources in GeBBS-owned offshore and domestic facilities results in higher quality, faster turnaround and a lower cost to our customers. This process, in turn, allows us to meet and/or exceed our corporate mission by allowing our customers to: |
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Pay claims faster, more accurately and at a lower cost |
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Reduce internal administrative expenses and increase profitability |
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GeBBS uses highly structured and controlled processes that deliver timely and consistent data capture product. Our processes have multiple tracking, control, and audit points from which statistics and performance reports are easily generated. Some of the features include: |
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Indexing functions that are integrated to meet the client's requirements |
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Once the claims are scanned the images are sent to an image queue for submittal, via high-speed data line into our ClaimsPro engine. The images are distributed based on pre-determined criteria to our India facility for data capture processing via OCR and KFI. Furthermore, a second level of distribution is implemented whereby individual data entry operators are assigned various volume levels based upon their skill and performance levels. |
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Verification/Validations: As part of the data capture process, GeBBS performs comprehensive healthcare-specific data validations as well as edits against the customer rule-sets and eligibility/provider files |
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Double Key Process: As required, GeBBS can utilize a double key process to ensure the highest level of data accuracy for key fields. This process consists of keying claims twice and then comparing the results. Differences in the field data are arbitrated by a third person, and errors are logged against the keyer who captured incorrect field data. |
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All of the technology, hardware, software and personnel resources described above are driven by ClaimsPro, our proprietary workflow engine and are designed and guaranteed to be fully HIPAA compliant. |
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Revenue Cycle Management
