INSURANCE BACK OFFICE PEAK HANDLING & AUTOMATION

Insurance Pre-screening and Validation Process

Insurance providers daily receive high amounts of insurance claims. Each provider has a different claim application standard and format. A Claim-form can contain many errors (e.g. redundant, wrong or missing supporting document, wrong formats). Correcting these errors is very complicated and time-consuming. Our operators receive extensive training and have deep knowledge of insurance claims in order to be able to recognize and correct errors in a timely manner.

DIGI-TEXX’s operators work directly in our client’s system, to edit claims. classify applications and correct errors. We help to reduce cost and errors while improving its efficiency. We handle different types of insurance documents: Claim form, ID card/passport, Investigation reports, Medical records, Histopathology report, Operation theatre notes, X-Rays, Lab reports, Blood tests, Supporting invoice, Hospital main bill, Break-up bill, Receipt for amount paid in the hospital, Prescriptions for medicines and so on.

During peak times with high variance in claim submission volume, DIGI-TEXX‘s service continuity is still guaranteed.

Diagnosis Standardization or Coding

The insurance claim process is an interaction between a healthcare provider (e.g. hospitals, clinics) and an insurance company. During this process, to claim bills accurately, the doctor’s diagnosis is translated into a series of insurance codes (e.g. Codes Current Procedural Terminology). 

Doctors and healthcare providers write diagnosis in different styles, many in handwritten format. This can be very challenging for insurance companies. 

At DIGI-TEXX our team takes part in the claim process by matching the diagnosis with the international insurance codes. There are billions of matching possibilities. We work directly on our client’s cloud system. We offer a full solution of processing diagnosis content. Our advanced OCR automatically detects and extracts relevant terms. The clean and clear digital diagnosis will become the main data sources for the rest of the claim processing circle.

With DIGI-TEXX service, our insurance client can effectively automate its claim and payment process. Our services reduces the code mismatching , ensuring correct billing in a short time.

 

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