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Insurance and Healthcare Insights

The insurance claim process is an interaction between a healthcare provider (e.g. hospitals, clinics) and the insurance companies as payers. During this claim process, for accurate billing purpose, after a visit, the doctor’s diagnosis are translated into a series of insurance codes (e.g. Codes Current Procedural Terminology). 

Our team at DIGI-TEXX takes part in the claim process by matching the diagnosis blocks with the international insurance codes. There can be some billions possible code combinations, while the diagnosis notes are different from one doctor to another. The work is done in the cloud system of our insurance client.

With DIGI-TEXX service, our insurance client can effectively automate its claim and payment process. Moreover, our services reduce the insurance company’s mismatching of codes, ensuring the correct billing in a short time.

Insurance providers typically receive high quantities of insurance claims each day. Each insurance provider may have their own submission standard and format in which the claim application should be followed. Claim submissions can contain many errors (e.g. redundant, wrong or missing supporting documents, wrong formats). The clearing and formatting task for each claim is time-consuming and complicated. Our operators receive extensive training and have deep knowledge of insurance claims in order to be able recognize and correct errors in a timely manner.

DIGI-TEXX’s operators will connect to the insurance company’s system to edit claims directly, classifying applications and scrubbing out any errors. The insurance company reduces costs and procedural errors while improving its competitiveness thanks to DIGI-TEXX‘s BPO services. Moreover, after holiday seasons when the insurance client may experience high variance in claim submission volume, DIGI-TEXX‘s service continuity is still guaranteed.