One of our main focus is on improving the administration process for insurance companies. Our team is able to achieve fast adjudication by consolidating different data management processes. We are able to increase productivity by automation through new technology tools and improve functionality by building suitable dashboards which in turn help in continuous process improvement.

Our company’s experience and innovative technological strengths help in ensuring claim accuracies by scrutinizing claim records i.e. patient names and diagnostic codes and also process claims that are valid and reimbursable.

Our robust claim management software and security systems in place help us in offering state of the art service while supporting our client’s security objectives by the protection of data. With teams both in service and development, eExpedise is equipped with the intelligence tools required to deliver high caliber service to our clients.

As a result, our clients benefit from our experience in medical cost containment and from substantial discounts which we have negotiated with our extensive network of providers

Some of the key features and benefits of our Claim Adjudication process includes:

  1. Benchmarking competency parameters: This helps in automating complex calculations to drive high auto-adjudication rates and minimize the risk of paying claims incorrectly.
  2. Reduction in TAT by customized technology tools closely interfaced with the client’s claims processing system.
  3. Productivity enhancement and Cost savings: With detailed date tracking, including diagnosis, procedure, provider type, units of time reduces costs and increases productivity.
  4. Eligibility check and detection of fraudulent claims: Our data analysis tools help to make fraud review and detection possible even in areas such as underwriting, policy renewals, and in periodic checks that fit right in with modeling.