Outsource Medical Claims Processing Service

We bank on our experience to lend speed, accuracy and efficiency to your claims process

Home Medical Claims Processing

Medical Claims Processing - Streamlined for Quick Results

DigiMedix help healthcare providers increase their revenues by professionally organizing the process of medical claims. We commit to our client’s services that are accurate, efficient, and flexible. Our aim is to provide the most optimal and reliable way for our clients to deal with. Most of our models find their basis through the rejected claims. These are created by our special teams that work for catering to your needs regarding monitoring, understanding, and thus, moving forward with the claims that have been rejected. We make sure to analyze the progress in real-time and work on the efficiency of the stages that are involved in the process of medical claims related to the management process. Through our claims, our aim is to serve with solutions that are both cost and time-effective.

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Provision of the expedited resolutions for claiming the deficiencies like missing data and errors alongside prior authorization

Management of all claims that are related to the correspondence for following up with the payer

Conversion of all the documents into the digitized files for all the paperwork that can form as a part of a large and central repository

Provision of comprehensive reports related to the claim audits and adjudication and real-time settlement of the payment amount

Effective management of the claims of denied and rejected nature. Also, this includes correction of errors that have been committed and resubmitting these for final claims and approval

Our Well-Defined Health Insurance Claims Process

Data Entry

Recording all the relevant information through data entry

Correct Billing Errors

Scrutinizing all the documents related to errors and resolving them

Adjudicate Claims for Accuracy

Authentication of the accuracy related to the medical claims

Prepare Explanation of Benefits (EOB) Statement

Preparing the explanation of benefits (EOB) benefits

Claims Filing

File the claims with the insurance company

Claims Follow-Up

Conducting the claims regarding the follow-ups

Claims Status Update

Information related to the client’s status claim

Evaluate and Resolve Denied Claims

The process involving the denial of claims and resolving the errors

Resubmit Corrected Claim

Conducting the claims for their final stage and submission

We are Specialize in Medical Insurance Claims Processing

Auditing and claim support through data entry

We make sure that our team is recording all the relevant information through data entry. Scrutinizing all the documents related to errors and resolving them is catered to at all levels before entering. We are a team of qualified auditors who put the best use of their experience while using the data processing tools. We cater to all requirements like audit claims, conducting the underpayment analysis, and finding effective solutions related to recovery.

Setup for Insurance claim

Our team is well equipped to ensure the patients’ demographic information is properly accounted for, as well as, recorded accurately. We record all information related to their insurance, insurance payer, and policy number amongst others. We make sure that the process is done authentically so that there is no discrepancy for accuracy related to the medical claims. Also, we aim at preparing the explanation of benefits (EOB) benefits.

Filing the claims with an insurance company

By rendering the medical claims processing services, we make sure to verify the policy cover. Also, we further make sure that it has its effect on the date of service. We ensure conducting the claims regarding the follow-ups for accuracy so that there are minimum appeals and prevents denials. Also, we help in procuring the prior authorization from the payers’ end. We pay attention to the details and ensure that all the details are included or excluded accurately.

Claims Adjudication

We make sure that the information related to the client’s status claim is eligible for the remittance process and benefit determination. We possess a decade-long experience in electronic, as well as, manual claims adjudication. We have experience in catering to the management requirements of various healthcare professionals and hospitals by helping them with information related to eligibility, checking, processing of remittances, and benefit determination amongst others.

Claims Support & Auditing

The process involving the denial of claims and resolving the errors. Our team is home to specialists that have expertise in converting paper documents into digital files. Also, this helps in the proper storage of all the crucial data and eliminates the risk related to the data getting lost or misplaced. A digital archive ensures effective and reliable recordkeeping and patient billing.

Account Settlement

Account settlement as the process for conducting the claims for their final stage and submission is also well-covered and catered by the experienced professionals at DigiMedix. Our services include understanding the terms of the policy cover, claims, along with having a proper hand at the documentation related to the medical procedures and processes. This helps us in filing the claims accurately and in the prescribed time frame. After this, we make sure to follow up with the payment agencies till the process of getting the claim ends.

Specialties We Deal

  • Acupuncture
  • Allergy / Immunology
  • Andrology
  • Anesthesiology
  • Audiology
  • Bariatrics
  • Cardiology
  • Clinical Virology
  • Dentistry
  • Dermatology
  • Emergency Room
  • Emergency Medicine
  • Endocrinology
  • Environmental Medicine
  • ENT Neurology
  • Family Medicine
  • Forensic Medicine
  • Gastroenterology
  • Genetics
  • Geriatrics
  • Hematology
  • Internal Medicine
  • Infectious Disease
  • Mental Health
  • Neonatology
  • Nephrology
  • Neurology
  • Nuclear Medicine
  • Occupational Therapy
  • Obstetrics/Gynecology
  • Occupational Medicine
  • Otolaryngology
  • Ophthalmology
  • Optometry
  • Orthopedics
  • Osteopathy
  • Otolaryngology
  • Pain Management
  • Pathology
  • Pediatrics
  • Plastic Surgery
  • Psychiatry/Psychology
  • Radiology
  • Physiotherapy
  • Plastic Surgery
  • Podiatry
  • Preventive Medicine
  • Pulmonology
  • Rehabilitation Medicine
  • Reproductive Medicine
  • Rheumatology
  • Speech Therapy
  • Sports Medicine
  • Urology
  • Vascular Medicine

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FAQ's on Medical Claims Processing

What are Medical Claims Processing Services?

Medical claims processing services are any services that check medical bills or claims for adequate information, justification, and validation to reimburse the medical care cost to the healthcare provider. Healthcare claims processing services range from simple claims setup to claims adjudication, denial management, and claims settlement.

How will Medical Claims Outsourcing Help My Business?

When you outsource your medical claims to third-party service providers like us, you benefit from guaranteed HIPAA compliance and improved cash flow. We ensure a larger percentage of your claims get paid out to you. You also benefit from reduced errors and faster turnaround time.

How Long Does It to Take to Send Claims?

The average amount of time it takes to send a claim will vary from healthcare provider to healthcare provider. However, most states require insurers to pay claims within 30 to 45 days.




HIPAA Compliance


Clean Claims On First Submission


Increase in Collections

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