 |
| Claims entry and vertexing |
| |
| The Gurucare claims processing solution reduces the headaches
associated with managing paper claims, by transforming the paper-intensive
process into an efficient digital outsourced solution. Gurucare
facilitates accuracy increases and will significantly improve
your auto-adjudication rates of HCFA1500, UB92, Dental claims,
prescription drugs and Vision claims. |
| |
| Claims adjudication includes re-pricing, eligibility and coverage
verification, provider verification, diagnosis and treatment reconciliation
through CPT and diagnosis codes, etc. |
| |
| All Gurucare healthcare professionals are trained on multiple
adjudication platforms and plan designs. Our adjudicators are
competent in medical terminology and are proven analytical problem
solvers. New adjudicators are trained in an intensive 5-week program
covering the U.S. healthcare industry and claims adjudication.
Each adjudicator is reviewed and tested. Those who do not receive
a 90% or higher on all tests are not certified and do not continue
on to client-specific claims-adjudication training and certification.
|
| |
- Adjudication Process
- HCFA1500 and UB92 forms
- Benefit and coverage verification
- Benefit & procedure Codes
- Provider information
|
